Jobs at Molina Healthcare - Page 9

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Senior Quality Interventions/QI Compliance Specialist

Molina Healthcare - Boise, ID

Job Description Job Summary Molina'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...

Director, Agile Center of Excellence

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities • Provides managerial and technical direction for the SDLC methodology group • May have supervisory responsibility in instructing, assigning, directing and checking the work of the resources within their section/department. • Expert in Agile, Lean, Waterfall and IT Project SDLCs • Expert in DevOps and Release Management • Expert in the method...

Case Manager (RN)

Molina Healthcare - Irving, TX

Job Description Job Summary Molina 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...

Discharge Planner

Molina Healthcare - Laredo, TX

Job Description Job Summary Molina 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

Molina Healthcare - San Antonio, TX

Job Description Job Summary Molina 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, Provider Inquiry R&R

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina 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...

Medical Records Collector

Molina Healthcare - San Antonio, TX

Job Description Job Summary Molina's HEDIS/Quality Improvement Medical Records Collector will work collaboratively in outreaching to providers in order to pursue medical records via phone call, fax, mail, electronic medical record system retrieval and direct onsite pick up, for the HEDIS projects. Knowledge/Skills/Abilities • Under the direction of ...

Medical Records Collector

Molina Healthcare - Syracuse, NY

Job Description Job Summary Molina's HEDIS/Quality Improvement Medical Records Collector will work collaboratively in outreaching to providers in order to pursue medical records via phone call, fax, mail, electronic medical record system retrieval and direct onsite pick up, for the HEDIS projects. Knowledge/Skills/Abilities • Under the direction of ...

Pharmacy Services Representative (Customer Service Rep)

Molina Healthcare - Midvale, UT

Job Description Job Summary Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal a...

Medical Director - Med Surg Home Health

Molina Healthcare - Columbus, OH

Job Description Job Summary Responsible 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 requirements affecting ...

Sr Adjuster, Claims

Molina Healthcare - Long Beach, CA

Job Description Job Summary 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/Skil...

Supv, Inside Sales

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for day to day operations in regard to all functions that are performed by the Medicare Inside Sales Team. Other responsibilities for this position include but are not limited to: training new employees, monitoring and coaching the staff, coordinating work schedules, assigning workloads, and interacting with other Molina depar...

Manager, Projects

Molina Healthcare - Midvale, UT

Job Description Job Summary Focuses on process improvement, organizational change management, project management and other processes relative to the business. Project management includes estimating, scheduling, costing, planning and issue/risk management. Knowledge/Skills/Abilities • Ability to manage multiple complex, challenging projects simultane...

Sr Architect, IT Processes

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities • Be fully conversant with multiple estimation techniques – story points, UML, function points and other • Knowledge of capacity management and planning process for the organization. • Understand IT component or resource-level planning, IT-service-level planning and business estimate planning. • Conduct meetings with all areas of IT to validate...

Operational Excellence Program Manager

Molina Healthcare - Columbus, OH

Please refer to this Summary for Job Description and requirements: Ohio Plan Specific and this role: Operational Excellence Manager This Manager role will provide direct leadership to the Molina Ohio Operational Excellence team, which offers Lean / Six Sigma support and DMAIC project leadership within the Ohio Plan Healthcare Services department. In...