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Jobs at Molina Healthcare

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Care Review 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...

Sr Specialist, Provider Network Admin

Molina Healthcare - Louisville, KY

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 Analyst, Finance - Healthcare Preferred (REMOTE)

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...

Sr Actuarial Analyst - Healthcare Required (REMOTE)

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Knowledge/Skills/Abilities • Collaborate with Actuarial staff to complete IBNR estimates and rate adequacy studies. Document assumptions.

Specialist, Provider Network Admin

Molina Healthcare - Louisville, KY

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 Accountant

Molina Healthcare - San Juan, San Juan, Puerto Rico

Job Description Job Summary Use of general accounting principles and rules to create financial reports and analysis. Duties include all aspects of the Accounting function, such as, control of accounts and records, recording of transactions, analysis of financial data, preparation budgets, forecasts, financial statements and accounting schedules/reports, and auditing...

Care Review Clinician, Inpatient Review (BH)

Molina Healthcare - Oak Brook, IL

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, Provider Configura

Molina Healthcare - Long Beach, CA

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...

Director, Provider Contracts

Molina Healthcare - Irving, TX

Knowledge/Skills/Abilities Plans, organizes, staffs, and coordinates the Provider Contracts activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider contracts and contracting strategies. • Monitors and reports network adequacy for Medicare and Medicaid services. • ...

Rep, Customer Service 1

Molina Healthcare - Columbus, OH

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.

Program Manager, HCS

Molina Healthcare - Louisville, KY

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 Clinician, Prior Authorization

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...

Pharmacy Internal Monitor

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...

Pharmacy Technician REMOTE

Molina Healthcare - Cincinnati, OH

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...

Pharmacy Technician REMOTE

Molina Healthcare - Irving, TX

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...