Molina Healthcare Jobs - Page 2 | CareerArc

Jobs at Molina Healthcare - Page 2

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Community Engagement Specialist (Kenosha/Racine County)

Molina Healthcare - Milwaukee, WI

Job Description Job Summary Responsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages. Knowledge/Skills/Abilities • Under limited supervision, responsible fo...

Assoc Specialist, Provider Contracts

Molina Healthcare - Bothell, WA

Job Description Job Summary Responsible 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...

Manager, HEDIS Performance Measurement

Molina Healthcare - Troy, MI

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...

Rep, Customer Service 1

Molina Healthcare - Albuquerque, NM

Job Description Job Summary Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences.

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...

Sr Analyst, Healthcare Analytics - Remote

Molina Healthcare - Long Beach, CA

Job Description Job Summary 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. Knowledge/Skills/Abilities ...

Rep, Provider Inquiry R&R

Molina Healthcare - Doral, FL

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...

Rep, Customer Service 1

Molina Healthcare - Irving, TX

Job Description Job Summary Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences.

Provider Contracts Manager

Molina Healthcare - Troy, MI

Job Description Job Summary Negotiates agreements with highly visible providers who are strategic to the success of the Plan, including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers. Knowledge/Skills/Abilities • In conjunction with Director/Manager Provider Contracts,...

Medical Director

Molina Healthcare - Long Beach, CA

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 affect...

Dir, Appeals & Grievances

Molina Healthcare - Louisville, KY

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 Medicare and Medicaid

Sr. Medical Director, Health Plan

Molina Healthcare - Louisville, KY

Knowledge/Skills/Abilities Provides medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to Plan members, targeting improvements in efficiency and satisfaction for patients and providers, as well as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding ...

Specialist, Electronic Visit Verification

Molina Healthcare - Albuquerque, NM

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 specifica...

Specialist, Delegation Oversight

Molina Healthcare - Irving, TX

Job Description Job Summary Responsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with DMHC and DHCS requirements including delegation standards and requirements contained in the Molina Medical Compliance and Fraud, Waste and Abuse Program. Knowledge/Skills/A...

Sr Analyst, Finance

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial projects or programs. Duties include gathering, interpreting, and evaluating financial information; generating forecasts and analy...