Jobs at Molina Healthcare - Page 9

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Operational Excellence Process Consultant

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryLeads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of Molina Healthcare of Washington business process improvement and in the implementation of a business process improvement capability utilizing Lean methodology....

Supv, Member Services

Molina Healthcare - Columbus, OH

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 rel...

Program Manager

Molina Healthcare - Sacramento, CA

Job DescriptionJob SummaryManages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May...

Data Analyst

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryThe Data Analyst will be responsible for designing and implementing 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. You will gain insight into key business problems and deliverables by applying statistical a...

Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - Midvale, UT

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...

Analyst, Medicare Compliance

Molina Healthcare - Long Beach, CA

Molina Healthcare Inc. Medicare unit, referred to as Molina Medicare, operates MA-PDs plans and special needs plans that serve Medicaid dual eligible individuals in many states. Molina intends to expand its Medicare operations into new states and additional markets in existing states as opportunities arise. Each of Molina's Medicare Advantage plans arrange for the provision of compr...

Auditor, Claims Compliance

Molina Healthcare - Long Beach, CA

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.Kn...

Sr. Healthcare Analyst (Medicaid Encounters) OH

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryPerforms 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.Knowledge/Skills/Abili...

Analyst, Coding

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryEstablish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the...

Sr. Healthcare Analyst, (Medicaid Encounters) NY

Molina Healthcare - Syracuse, NY

Job DescriptionJob SummaryPerforms 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.Knowledge/Skills/Abili...

Instructional Designer

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryAnalyzes and determines training needs and problems. Develops, administers and implements all training programs in accordance with the Business' initiatives and strategies. Conducts special courses designed for training selected groups of employees.Knowledge/Skills/Abilities• Supports job-task analysis and/o...

RN Case Manager - REMOTE - Springfield, IL

Molina Healthcare - Springfield, 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...

Senior IT Security Engineer – Identity & Access Management

Molina Healthcare - Long Beach, CA

Job Description We are looking for an Security Access Management Sr. Engineer to join the AM Platform Engineering team and help build the next generation solutions that can scale with our business growth. Responsibilities Specify, design, and build Access Management (AM) solutions including Directory Services, PKI, SSO, Federation,...

Director, Process Management Optimization

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for evaluating existing processes and configuring clinical systems to reduce cost and develop best practices within clinical programs.Knowledge/Skills/Abilities• Participates as a member of a team designed to improve utilization management and case management functions within a managed care organ...

Senior Medical Director Clinical Decisions

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provision of medical staff services. Maintains a working knowledge of applicable national, state and local laws and regulatory require...