Jobs at Molina Healthcare

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Clerk

Molina Healthcare - Doral, FL

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 vario...

Sr Rep, Provider Services

Molina Healthcare - Boise, ID

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. Prov...

Analyst, IT Systems

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities• Prioritizes work assignments, ensures on-time completion of tasks and projects and provides timely updates to project group leader, managers and directors.• Fosters open communications and ensures effective and positive working relationships with coworkers, users and vendors. • Develops lifecycle system projects from design through codi...

Associate Representative, Provider Services

Molina Healthcare - Charleston, WV

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• Handl...

Senior Analyst, Healthcare Analytics

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryPerforms 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 findings.Knowledge/Skills/Abili...

Pharmacy Technician

Molina Healthcare - Troy, MI

Job Description Job 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 al...

Sr Auditor, Call Center Qualit

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryAnalyzes and measures the effectiveness of existing contact center processes and develops sustainable, repeatable and quantifiable process improvements. Collects and analyzes contact center activity data and initiates, develops and recommends improvements to systems, processes and procedures to increase productivity and reduc...

Auditor, Call Center Quality

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryAnalyzes and measures the effectiveness of existing contact center processes and develops sustainable, repeatable and quantifiable process improvements. Collects and analyzes contact center activity data and initiates, develops and recommends improvements to systems, processes and procedures to increase productivity and reduc...

Call Center Quality Auditor

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryAnalyzes and measures the effectiveness of existing contact center processes and develops sustainable, repeatable and quantifiable process improvements. Collects and analyzes contact center activity data and initiates, develops and recommends improvements to systems, processes and procedures to increase productivity and reduc...

Auditor, Quality

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryPerforms auditing activities in the Medicaid environment to ensure work is performed in accordance with internal and client expectations. Provides operational quality assurance and testing activities. Works with cross functional teams to identify and implement business process improvement opportunities. Monitors quality assur...

Analyst, Provider Configuration - Healthcare

Molina Healthcare - Troy, MI

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...

Supervisor, Provider Configuration Management

Molina Healthcare - Troy, MI

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. Abstractor, HEDIS/Quality Improvement

Molina Healthcare - Long Beach, CA

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/...

Sr. Abstractor, HEDIS/Quality Improvement - (4 Positions)

Molina Healthcare - Salt Lake City, UT

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. The Senior Abstracto...

Case Manager (RN)

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 ...