Jobs at Molina Healthcare - Page 5

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Supervisor, HCS Operations Support

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 toward desir...

Care Review Processor

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...

Pharmacy Technician

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryMolina 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...

Field Case Manager, RN or Social Worker (Walla Walla, WA)

Molina Healthcare - Spokane, 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 Processor-Care Review

Molina Healthcare - Columbus, OH

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...

CFO Medicare - VP Financial Planning & Analysis

Molina Healthcare - Long Beach, CA

CFO MedicareLong Beach, CA Relocation Available Medicare financial business needs Identify high member utilization, high unit costs to improve services In depth knowledge and experience with Medicare Understand CMS - Center for Medicare and Medicaid Services and reporting requirements Colaborate across company for coordination of Medicare business Managed Care / M...

Outreach Rep, Member Services (Long Beach, CA)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to service request and scheduling of quality visits by clinical staff in patient/member place of residence. This Member Outreach is an imperative aspect of our Quality Management of the Chronically Ill Patient. Provides service information to members...

Supervisor - Utilization Review (RN) E

Molina Healthcare - Columbus, OH

Job DescriptionOhio 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 the Medical Surg background. Job SummaryMolina Healthcare Ser...

Case Manager (RN)

Molina Healthcare - Houston, 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 toward desir...

Specialist, Appeals & Grievances Provider Research & Resolution

Molina Healthcare - Columbus, OH

Ohio Plan Specific: Duties and Responsibilities (List all essential duties and responsibilities in order of importance) · Research and document denial determinations at all levels of reconsiderations/appeals in a thorough, professional and expedient manner. · Coordinate workflow between departments and interface with internal and external resources. Formulate...

Sr. Data Analyst – Encounters

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryDesigns 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 fr...

Medical Director, Health Plan

Molina Healthcare - Oak Brook, IL

Knowledge/Skills/AbilitiesProvides 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, Medical Necessity Claims Reviewer

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...

Behavioral Health Specialist (LCSW)

Molina Healthcare - Everett, WA

Job DescriptionJob SummaryMolina's Behavioral Health Specialist provides active individualized and/or group therapy in a primary care setting which includes urgent mental health crisis intervention, chronic counseling, and community resources to manage patients' social needs. Behavioral Health Specialist will also provide continuous training and mentoring to clini...

Medical Assistant

Molina Healthcare - Spokane, WA

Job DescriptionJob SummaryMaximizes patient care and satisfaction by interacting with the staff, patients, and providers. Provides necessary patient care when applicable to impacted individuals on the basis of living a healthy life.Knowledge/Skills/Abilities• Responsible for performing patient oriented procedures under the clinical supervision o...