Molina Healthcare Jobs - Page 6 | CareerArc

Jobs at Molina Healthcare - Page 6

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Displaying results 76 - 90 of 327

Specialist, Appeals & Grievances (REMOTE)

Molina Healthcare - Long Beach, CA

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

NICU / PEDS Case Manager - Vancouver, WA

Molina Healthcare - Vancouver, WA

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...

Medical Director, Behavioral Health

Molina Healthcare - Louisville, KY

Job Description Job Summary Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. Knowledge/Skills/Abilities Provides Psychiatric leadership for...

Medical Director, Health Plan (Pediatric)

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 ...

Sr Analyst, Implementation MLTSS (Remote)

Molina Healthcare - Long Beach, CA

Job Description Job Summary Analyzes complexbusinessprocessesusingdatafrominternalandexternalsourcesto provideinsighttodecision-makers.Identifiesandinterpretstrendsandpatterns indatasetstolocate influences.Constructsforecasts,recommendationsandstrategic/tacticalplansbasedonbusinessdata andmarketknowledge.Createsspecificationsforreportsandanalysisbasedonbusinessne...

Case Manager, Idaho (Social Worker or RN)

Molina Healthcare - Long Beach, CA

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...

Program Manager MLTSS (Remote)

Molina Healthcare - Long Beach, CA

Job Description Job Summary Join one of the industry leaders inManaged Long Term Services and Supports (MLTSS). This position collaborateswith Molina MLTSS programs across the nation in an exciting role thatinfluences how LTSS services are delivered to individuals, ensure quality ofand person centered practices both at the enterprise and ...

Case Manager : Member Health Assessment Team

Molina Healthcare - North Charleston, SC

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...

Senior Proposal Writer - Medicaid Proposals (Remote)

Molina Healthcare - Long Beach, CA

Job Summary Provides content development, compilation, editing and submission of proposals for government sponsored managed care programs or health care related areas. Works across the organization to develop specific response-focused, technically accurate content. Supports RFP, RFA, and RFI response projects, while contributing to procurement opportunities and development...

Case Manager RN (BSN Preferred)

Molina Healthcare - North Charleston, SC

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...

Care Review Processor

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...

Sr. Specialist, Provider Network Admin

Molina Healthcare - Troy, MI

Job Description Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts....

Sr Engineer, Big Data

Molina Healthcare - Long Beach, CA

The Sr. (Foundational) Big Data Engineer Role The Sr. Big Data Engineer plays a critical role in the construction, maturation and optimization of the foundational components of the big data platform, especially data pipelines. He/she scales the agnostic framework to meet the rapidly-growing, ever-changing business analytics needs of the business, including the migratio...

Sr. Abstractor, HEDIS/Quality Improvement - Remote in Ohio

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina's Quality Improvement Sr. Abstraction team functions to conduct data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction team will meet chart abstraction productivity standards as well as minimum over read standards. Knowledge/Skills/Abili...

Correspondence Processor

Molina Healthcare - San Antonio, 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...