Jobs at Molina Healthcare - Page 8

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Case Management Processor -Field-CENTREVILLE, IL

Molina Healthcare - Centreville, IL

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...

Specialist, Quality Interventions/QI Compliance

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryMolina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities...

Associate Rep, Provider Inquiry R&R

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryMolina Health Plan Operations jobs are responsible for the development and administration of our State health plan's operational departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.Provide...

Corporate Recruiter

Molina Healthcare - Long Beach, CA

Job Description Summary: Develops and implements staffing strategies including development of sourcing approaches, interview and selection processes and company branding. Knowledge/Skills/Abilities: 1 – 3 years' experienceConfers with hiring managers to identify personnel needs, search assignments. Visits hiring managers to ...

Non RN, Case Manager (Bothell, WA)

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...

Nurse Practitioner, Remote (Spokane, WA)

Molina Healthcare - Spokane, WA

Job DescriptionJob Summary Molina Healthcare, seeks Nurse Practitioners to join its growing team which will contribute to the company mission to bring quality health care to the under-served. The clinic Nurse Practitioners (NP) focus on screening and preventive primary care services delivered in the clinic and possibly home, community and nursing facility ...

Outreach Rep, Member Services (Long Beach, CA)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to service request and scheduling of quality visits by clinical staff in patient/member place of residence. This Member Outreach is an imperative aspect of our Quality Management of the Chronically Ill Patient. Provides service information to members...

Provider Services Rep

Molina Healthcare - Syracuse, NY

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. Provi...

Supv, Claims Adjustments

Molina Healthcare - Long Beach, CA

Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.Knowledge/Skills/Abilities• Ensures execution of claim han...

Specialist, Claims Recovery

Molina Healthcare - Spokane, WA

Job DescriptionJob SummaryResponsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.Knowledge/Skil...

Dir, Process Improvement & Op Excellence

Molina Healthcare - Long Beach, CA

Leads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of MHI's business process improvement methodology and in the implementation of a business process improvement capability.Knowledge/Skills/Abilities• Defines program scope, establish approach for implementation and main...

Case Manager, RN or SW (North Sound)

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 (Sacramento, CA)

Molina Healthcare - Sacramento, 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...

Sr Analyst, Healthcare Analytics - Columbus, OH

Molina Healthcare - Columbus, OH

Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.SQL knowledge and daily working with developing ad-hoc repo...

Prior Auth LPN Reviewer (MMS)

Molina Healthcare - Baton Rouge, LA

Job DescriptionJob SummaryResponsible for reviewing and resolving DME (Durable Medical Equipment) prior authorization requests. Reviews include initials and reconsiderations.Knowledge/Skills/Abilities• Accesses the ePA and automated prior authorization systems and the DHH criteria, assuring contractual requirements are accomplished by maintainin...