Jobs at Molina Healthcare

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Supv, Health Plan Pharmacy Ops

Molina Healthcare - San Juan, Puerto Rico

Job DescriptionJob SummaryMolina 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...

Case Manager RN (Field: Coeur d'Alene, ID)

Molina Healthcare - Coeur D'alene, ID

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...

Manager, Healthcare Services - LTSS Experience

Molina Healthcare - Boise, ID

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...

Case Manager RN (Field: Twin Falls, ID)

Molina Healthcare - Twin Falls, ID

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...

Specialist, Quality Interventions/QI Compliance (Provider Engagemet)

Molina Healthcare - Grand Rapids, MI

Job Description Job 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 activiti...

Clinical Services Trainer (LSW) Remote

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities• Provides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state and federal regulations and guidelines. • Responsible for the development and implementation of training curriculum for Utilization Management, Case Management, and LTSS staff.• Responsible for evaluation of ...

Nurse Practitioner: remote (Franklin County, OH)

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryCare Connections, a division of Molina Healthcare, seeks Nurse Practitioners to join its growing team which will contribute to the company mission to bring quality health care to the under-served. The Care Connections NPs focus on screening and preventive care services delivered in the home, community and nursing facility settings. As a c...

Nurse Practitioner: remote (Hamilton County, OH)

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryCare Connections, a division of Molina Healthcare, seeks Nurse Practitioners to join its growing team which will contribute to the company mission to bring quality health care to the under-served. The Care Connections NPs focus on screening and preventive care services delivered in the home, community and nursing facility settings. As a c...

Analyst, Healthcare Analytics - 2 positions

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryThe Analyst, Healthcare Analytics will perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant find...

Director, Regulatory Affairs

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryResponsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.Knowledge/Skills/Abilities• Responsible ...

Specialist, Quality Interventions/ QI Compliance

Molina Healthcare - Albuquerque, NM

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...

HR Business Partner Manager : Employee Relations

Molina Healthcare - Jackson, MS

Job DescriptionJob SummaryProvides strategic and operational HR consultation to assigned client groups, which may be located in multiple States. Responsible for the assessment of HR initiatives to support business strategies. Collaborates with Centers of Expertise (COEs) to develop and implement HR programs to meet business objectives. Provides compreh...

Care Review Processor

Molina Healthcare - Columbus, OH

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...

Care Review Clinician, Prior Authorization

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...

RN SIU Investigator - (Miami, FL)

Molina Healthcare - Doral, FL

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...