Jobs at Molina Healthcare - Page 2

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Certified Coder

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryProvides support to the business by making sure proper procedures are recorded accurately. Thus brings minimal risk to denials.Knowledge/Skills/Abilities• Primary resource for medical coding updates and information.• Provides advice on coding issues and researches procedures.• Reviews coding procedure coverage w...

Analyst, Healthcare Analytics

Molina Healthcare - Midvale, UT

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...

Assoc Rep, Provider Services (MMS)

Molina Healthcare - Boise, ID

Job DescriptionJob SummaryResponsible for answering all calls from providers regarding claims issues, eligibility and benefits, and website assistance in a call center setting, and to satisfactorily resolve calls within expected response time standards. May also answer and resolve calls from members.Knowledge/Skills/Abilities• Handles heavy inbo...

Analyst, Clinical Informatics, Reporting & Analytics

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for the design, development, implementation, maintenance and support of critical business reports based on data stored in multiple business applications. CIA-RA is expected to translate business requirements into specifications for requested report, gap analysis, changes to existing reports and/or identify delivered reports al...

Nurse Practitioner (Field: Bloomington, IL)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryCare Connections, a division of Molina Healthcare, seeks Nurse Practitioners to join its growing team which will contribute to the company mission to bring quality health care to the underserved. The Care Connections NPs focus on screening and preventive primary care services delivered in the home, community and nursing facility set...

Sr Project Manager, PMO

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryFocuses 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• Deep understanding of effective project approach(es) for a variety...

Assoc Specialist, Provider Contracts

Molina Healthcare - Syracuse, NY

Job DescriptionJob SummaryResponsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on...

Sr Analyst, Business Systems - Market Place

Molina Healthcare - Long Beach, CA

Market PlaceHealth Insurance Exchange ACA - American Care ActInterfaces with the customer in developing requirements for major projects of considerable complexity; prepares system design specifications; conducts research to resolve customer initiated issues related to Market Place / ACA claims processing; and coordinates and manages project teams in the developmen...

Interpreter

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryTo assist staff with Spanish speaking members by providing over the phone interpretation throughout the triage process. To offer excellent customer service by listening and interpreting the callers issues in a clear and concise mannerKnowledge/Skills/Abilities• Provide Consecutive interpretation services over the phone

Clinical Services Trainer

Molina Healthcare - Jackson, MS

Knowledge/Skills/AbilitiesProvides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state and federal regulations and guidelines. Responsible for the development and implementation of training curriculum for Utilization Management, Case Management, and LTSS staff.• Responsible for evaluation of training eff...

Clinical Services Trainer (RN)

Molina Healthcare - Jackson, MS

Knowledge/Skills/AbilitiesProvides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state and federal regulations and guidelines. Responsible for the development and implementation of training curriculum for Utilization Management, Case Management, and LTSS staff.• Responsible for evaluation of training eff...

Case Manager, Non RN (San Diego, CA)

Molina Healthcare - San Diego, 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...

Regional VP, Finance & Analytics - Bilingual

Molina Healthcare - Doral, FL

Regional VP, Healthcare Finance & Analytics Regional Locations: Florida and Puerto Rico Requires: Fluent Bilingual in Spanish Responsible for leading a Region finance organization providing financial analysis to make sound business decisions including profit improvement initiatives for medical management metrics, Member Growth/Rete...

Care Review Clinician (LPN/LVN)

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...

Lead, Provider Inquiry R&R

Molina Healthcare - Troy, MI

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...