Jobs at Molina Healthcare - Page 7

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Mgr, HEDIS Performance Measurement

Molina Healthcare - Midvale, UT

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...

Sr Architect, Info Systems

Molina Healthcare - Long Beach, CA

Job Description Job Summary Architects company specific systems and technology expertise across multiple infrastructure and development disciplines. Applies and promotes key principles (e.g. stability, scalability, performance, security, compatibility, re-use), helping ensure a balance between tactical and strategic technology solutions. Considers business proble...

Architect, Info Systems

Molina Healthcare - Long Beach, CA

Job Description Job Summary Architects company specific systems and technology expertise across multiple infrastructure and development disciplines. Applies and promotes key principles (e.g. stability, scalability, performance, security, compatibility, re-use), helping ensure a balance between tactical and strategic technology solutions. Considers business proble...

Mgr, Provider Engagement Team

Molina Healthcare - Cayce, SC

Job Description Job Summary Develops and implements enterprise-wide initiatives and projects supporting provider engagement. Responsible for continuous quality improvements. Supports robust provider engagement to achieve positive operational and financial outcomes. Knowledge/Skills/Abilities • Leads and facilitates multidisciplinary Provider Engagem...

Assoc Specialist, Provider Contracts

Molina Healthcare - Columbus, OH

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...

Engineer, Big Data

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for collecting, storing, processing, and analyzing large sets of data. The primary focus will be on choosing optimal solutions to use for these purposes, then maintaining, implementing, and monitoring them. He/she will also be responsible to follow architecture and best practices used across the enterprise. Knowledge...

Sr Program Specialist, Medicare

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for the management of the annual benefits submission, core member communications, KPI reporting, and data exchange of the Medicare/MMP product in support of strategic and corporate business objectives. Manage all Medicare lines of business for the annual Medicare and Medicare-Medicaid Plan Benefit Package design, as well a...

Mgr, Pharmacy UM/Prior Authorization

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina 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...

Senior Graphic Designer - Office of the CEO

Molina Healthcare - Long Beach, CA

Job Description Job Summary Creates designs that viscerally engage and influence behavior throughout materials used in investor presentations and employee engagement campaigns. Uses and creates brand guidelines or visual language systems. Engages the elements of photography, typography, graphic layout, color, style, etc. to deliver the intended message. Consults with i...

Senior Engineer, Info Sec

Molina Healthcare - Long Beach, CA

Job Summary Responsible for ensuring Molina compliance with both regulatory and company Information Security policies. Conduct various types of Information Security compliance and risk assessments. Monitor compliance by internal business units with security standards and policies. Maintain an awareness of state, federal, and company-established Information Sec...

Manager, Healthcare Services ( Prior Authorizations )

Molina Healthcare - Bothell, 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...

Case Manager (RN)-Remote-Tri-Cities or Walla Walla

Molina Healthcare - Spokane, 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...

Provider Services Associate Rep

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina 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...

Sr. Abstractor, HEDIS/Quality Improvement

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...

Sr Account Rep, Medicare - Michigan (REMOTE)

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability and retention goals, while following ethical sales practices and adhering to established policies and procedures.