Jobs at Molina Healthcare

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Assoc Specialist, Corp Credentialing

Molina Healthcare - Spokane, WA

Job DescriptionJob SummaryMolina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria in order to minimize liability to the company and to maximize safety for members.Knowledge/Skills/AbilitiesResponsible for coordinating assigned aspe...

Assoc Specialist, Corp Credentialing

Molina Healthcare - Spokane, WA

Job DescriptionJob SummaryMolina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria in order to minimize liability to the company and to maximize safety for members.Knowledge/Skills/AbilitiesResponsible for coordinating assigned aspe...

Project Coordinator

Molina Healthcare - Troy, MI

Job DescriptionJob SummaryProvides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. May also perform a variety of activities in support of the functional processes, programs and/or services. Also provides the administration of variou...

Sr Specialist, Provider Contracts

Molina Healthcare - San Diego, 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...

Analyst, Coding

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...

Provider Contracts Specialist

Molina Healthcare - San Diego, 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...

Sr Specialist, Provider Contracts

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 ...

Analyst, Dental

Molina Healthcare - Baton Rouge, LA

Job DescriptionJob SummaryInvestigates and resolves cases involving aberrant dental practices. Reviews claims using records and system reports to determine proper documentation, utilization and appropriateness of services and to identify possible fraud and abuse.Knowledge/Skills/Abilities• Performs post payment analysis of claims and...

Specialist, Health Plan Communications

Molina Healthcare - Milwaukee, WI

Job Description Job SummaryResponsible for the development of communications and marketing activities aimed at brand and message management. Develops, implements, and manages communications programs.Knowledge/Skills/Abilities• With minimal supervision, writes and develops content to support the creation of internal and external communi...

RN Care Review Clinician, Inpatient Review

Molina Healthcare - Doral, FL

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 ...

Case Manager

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...

Sr Rep, Enrollment

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections....

Rep, Provider Services

Molina Healthcare - Albuquerque, NM

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. Provi...

Care Review Processor

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 ...

Provider Services Rep (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• Inter...