Molina Healthcare Jobs - Page 10 | CareerArc

Jobs at Molina Healthcare - Page 10

317 job openings

Save This Search

Refine Your Search

Show more Show less
Displaying results 136 - 150 of 317

Sr. Account Representative, Medicare (Hidalgo / McAllen, TX)

Molina Healthcare - Edinburg, TX

Job Description Job Summary Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability and retention goals, while following ethical sales practices and adhering to established policies and procedures.

Analyst, Network Strategy, Pricing & Analytics

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for supporting and validating Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting. Perform financial modeling to support well-informed negotiations, anticipating issues resulting in the ability to reach contract terms with good faith with sust...

Sr Analyst, Config Info Mgmt

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adhe...

Sr Capacity Planner

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities Develop and deploy workforce management strategies nationwide. Partner with leaders by strategically identifying business needs, and propose solutions in line with the needs of our members and providers. Requires contact center experience with in-depth Workforce Management experience specializing in planning efforts. Ensures the right numbers of skilled ...

Auditor, Clinical Services

Molina Healthcare - Oak Brook, IL

Knowledge/Skills/Abilities • Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM). • Monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May also perform non-clinical system an...

Care Review Clinician, PA (RN) LTSS

Molina Healthcare - Syracuse, NY

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...

RN Program Manager, Delegation Oversight

Molina Healthcare - Albuquerque, NM

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...

Lead Analyst, Config Info Mgmt (QNXT)

Molina Healthcare - Long Beach, CA

Job Description Job Summary: Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adheren...

Sr. Analyst, Business

Molina Healthcare - Long Beach, CA

Job Description Job Summary: Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specificatio...

Production Manager (Government Proposals/RFP) - Remote

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities Responsible for leading and managing all aspects of government proposal response documentation, coordinating the internal flow and review of all proposal content, directing as well as formatting and production of the final books and materials. Documents range from a few pages to multi-thousand. The ability to multi-task and effectively prio...

Specialist, Provider Inquiry R&R

Molina Healthcare - Bothell, WA

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...

Manager, Healthcare Analytics

Molina Healthcare - Irving, TX

Job Description Job Summary: Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and deploying reports to provider networks and other end users for operational and strategic analysis. Knowledge/Skills/Abilities: Manages and provides direct oversight of Healthc...

Analyst, Data (SQL/Power BI)

Molina Healthcare - Long Beach, CA

Job Description Job Summary: Designs 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 from ...

Specialist, Appeals & Grievances (WISCONSIN LOCATION)

Molina Healthcare - Milwaukee, WI

Job Description Job Summary Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Marketplace and Medicaid...

Sr Rep, Provider Services

Molina Healthcare - Syracuse, NY

Job Description Job Summary Molina 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...