Jobs at Molina Healthcare

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Sr Analyst, Business

Molina Healthcare - Long Beach, CA

Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business need...

Transition of Care Coach (RN)

Molina Healthcare - East St Louis, 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...

Transition of Care Coach (RN)

Molina Healthcare - Peoria, 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...

Provider Contracts Manager (Contract Negotiations)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible 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...

Transition of Care Coach RN or Licensed Social Worker

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...

Sr Account Rep, Medicare (Dallas, TX)

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible 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.

Bilingual Call Center Rep (Medicare Preferred)

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member relationships. R...

Assoc Rep, Provider Services (MMS)

Molina Healthcare - Augusta, ME

Job DescriptionJob SummaryResponsible for answering all calls from providers regarding claims issues, eligibility and benefits, and website assistance in a call center setting, and to satisfactorily resolve calls within expected response time standards. May also answer and resolve calls from members.Knowledge/Skills/Abilities• Handles heavy inbo...

Rep, Provider Services

Molina Healthcare - Jackson, MS

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...

Rep, Provider Services

Molina Healthcare - Jackson, MS

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...

Analyst, SIU

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryEstablish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care...

Medicaid Case Manager (RN)

Molina Healthcare - Independence, OH

Job DescriptionState of Ohio Plan requires a Registered Nurse for this role. We have expanded our services in the Independence office to reach out to Maternal Child members. Preference is given to those candidates with that background or open to that type of work. We would love to have someone who has a heart for the autistic child. We are changing lives, come join us. J...

Clinical Services Auditor (RN)

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities• Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM) and monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May also perform non-clinical system and proc...

LVN Case Manager

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...

Member Services/Claims Reps (Call Center)

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryProvides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member relationships. R...