Jobs at Molina Healthcare - Page 3

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Specialist, HEDIS/ Quality Reporting

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryMolina'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...

AVP, Health Plan Quality Improvement

Molina Healthcare - Bothell, WA

Job DescriptionJob Summary The AVP, Health Plan Quality Improvement will serve as a leader of the health plan Quality strategy and activities, including but not limited to leadership and primary Molina interface with state agencies, leadership of local Quality committees and oversight of intervention activities intended to improve quality measures and ...

Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - El Paso, TX

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 ...

Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - Irving, TX

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 ...

Field Representative, Provider Services (Eastern San Diego County, CA)

Molina Healthcare - San Diego, CA

Job DescriptionJob SummaryMolina 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...

Field Representative, Provider Services (South San Diego County, CA)

Molina Healthcare - San Diego, CA

Job DescriptionJob SummaryMolina 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...

VP, Healthcare Services

Molina Healthcare - Troy, MI

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...

Analyst, Healthcare Analytics - entry level

Molina Healthcare - Oak Brook, IL

Job Description Job 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/Abilit...

Supvr Utilization Review (RN) SIGN ON BONUS

Molina Healthcare - Columbus, OH

Job Description (SIGN ON BONUS)Ohio Plan Specific: This role is part of our Utilization Management team. You would be supervising a team of Seasoned Nurses who are responsible for the Prior Authorization and evaluation of medical needs for our members. This role would be great for an experienced Nurse from a Medical Surg background. Job SummaryMolina ...

Correspondence Processor - Clerk

Molina Healthcare - Bothell, WA

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...

Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - Oak Brook, 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 toward desir...

PART TIME: Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - Oak Brook, 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 toward desir...

Senior Advice Line Rep (Call Center)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryAnswers calls from numerous clients ranging from the general community to physician practice clients, managed care members, and Home Care patients. Performs health assessments using computerized guidelines. Provides general health information using approved references. May provide physician referrals and community service referrals as nee...

Director Healthcare Enrollment Services - Florida Office

Molina Healthcare - Doral, FL

Director of Enrollment Services Office and Staff location: Florida, Miami Doral Must be willing to relocate to Florida Office Relocation assistance available Region Coverage: Florida, South Carolina, New York, and Puerto RicoResponsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member ...

Engineer, MITA Integrated Solutions

Molina Healthcare - Boise, ID

Job DescriptionJob SummaryContributes, from a solution standpoint, in either an Implementation or Customer Support team around one or more Integrated Solution components. Working on our Provider Enrollment application that interfaces with our Process Manager application to ensure documents are communicating correctly between the two applications.Kn...