Jobs at Molina Healthcare

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Supv, Care Management (Behavioral Health)

Molina Healthcare - San Juan, Puerto Rico

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...

Part-Time Claim Services Reps (12 Openings, Bilingual Required)

Molina Healthcare - Long Beach, CA

Job DescriptionProvides 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. Recommends and implements p...

Care Review Processor (Customer Service / Call Center)

Molina Healthcare - Bothell, WA

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...

Full Time Claims Services Reps (15 Openings)

Molina Healthcare - Jackson, MS

Job DescriptionProvides 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. Recommends and implements p...

Part-Time Claim Services Reps (12 Openings, Bilingual Required)

Molina Healthcare - Pomona, CA

Job DescriptionProvides 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. Recommends and implements p...

Manager, Provider Inquiry R&R (Claims Disputes)

Molina Healthcare - Long Beach, CA

Job Description Job SummaryProvider Inquiry/Services staff are responsible for the submission, research, and resolution of provider inquiries and/or disputes. They respond with the answer to all incoming inquiries and coordinate with other Molina departments as needed to resolve the issue, as well as to correct the underlying cause, ensuring that res...

Specialist, Facilities

Molina Healthcare - Jackson, MS

Job DescriptionJob SummaryMolina's Facilities function is responsible for the efficient planning, design, integration and operation of the different elements that make up a work environment. Depending on location, this includes: day-to-day facility operations management and administrative services (e.g., mailroom, reception, relocation/move support, mainte...

Receptionist

Molina Healthcare - Long Beach, CA

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 various programs, ...

Care Review Clinician, Inpatient Review (LPN/LVN)

Molina Healthcare - Albuquerque, NM

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. Specialist, Quality Interventions/QI Compliance

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryMolina'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. Abstractor, HEDIS/Quality Improvement

Molina Healthcare - San Antonio, TX

Job DescriptionJob SummaryMolina'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...

Lead, Core Ops

Molina Healthcare - San Juan, Puerto Rico

Job DescriptionJob SummaryResponsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.Knowledge/Skil...

Full-Time Member Services Reps (20 Openings,Bilingual/Spanish Required)

Molina Healthcare - Jackson, MS

Job DescriptionProvide new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolvemember inquiries and complaints fairly and effectively. Provide product and service information to members, and identifies opportunities to maintain and increase member relationships. Recommend and implement program...

RN SIU Investigator - PR

Molina Healthcare - San Juan, Puerto Rico

Job DescriptionJob SummaryThe Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing revi...