Jobs at Molina Healthcare - Page 8

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Assoc Rep, Provider Services

Molina Healthcare - Augusta, ME

Job DescriptionJob SummaryMolina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services...

Senior Applications Engineer (Remote)

Molina Healthcare - Aurora, CO

Job Description Job summary: Responsible for designing, developing, coding, unit testing, and debugging new software and producing significant enhancements to existing software. Conducts business process analysis, participates in design sessions with Architects in order to align information technology solutions with business initiatives.Applies and promotes ...

RN Case Manager - Milwaukee Office

Molina Healthcare - Milwaukee, WI

Job DescriptionJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desir...

Associate Specialist, Provider Network Administration

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryProvider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts....

Associate Specialist, Provider Network Admin

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryProvider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts....

Director, Fraud Waste and Abuse Vendor Oversight and Operations

Molina Healthcare - Long Beach, CA

1) Critical requirements are: (1) Experience in an Special Investigations Unit (SUI) unit in healthcare, (2) Knowledge of Managed Care Organization (MCO), market place, medicaid and medicare billing, (3) prior experience with complex systems and workflows, (4) development of quality assurance measures and tracking 2) Acts as liaison between Special ...

Manager, Healthcare Services

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desir...

Case Management Processor

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desir...

Case Manager, RN or Social Worker (Grays Harbor County: Remote/Field )

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desir...

Delegation Oversight Nurse (LVN or RN)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA, CMS and State Medicaid requirements including delegation standards and requirements contained in the delegation agreement.Knowledge/Skills/AbilitiesThe Deleg...

Call Center Supervisor, Member Services

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member relationships. R...

Senior Data Analyst

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryDesigns and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data fr...

Lead Applications Engineer - REMOTE Position

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for designing, developing, coding, unit testing, and debugging new software and producing significant enhancements to existing software.Conducts business process analysis, participates in design sessions with Architects in order to align information technology solutions with business initiatives....

Field Representative, Provider Services (Central San Diego County, CA)

Molina Healthcare - San Diego, CA

Job DescriptionJob SummaryMolina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services...

Remote Sr Analyst, Config Info Mgmt SSIS, SSRS

Molina Healthcare - Long Beach, CA

Design and develop SSIS packages. Use SQL to build complex reports. Use SQL to update configuration data in a SQL Server database. Work with BA to understand requirements of SSIS packages, reports and configuration updates. Execute and maintain SSIS packages. Q/A results of reports, scripts, and SSIS packages. Write technical and user documentation for queries, reports, and SSIS pac...