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Jobs at Molina Healthcare

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Sr. Abstractor, HEDIS/Quality Improvement

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina'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/Abil...

Case Manager (RN)

Molina Healthcare - Irving, TX

Job Description Job Summary Molina 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 desi...

Nurse Practitioner, Field (Seattle, WA)

Molina Healthcare - Bothell, WA

Job Description Job Summary Care 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 underserved. The Care Connections NPs focus on screening and preventive primary care services delivered in the home, community and nursing facility settings...

Care Review Clinician, Prior Authorization

Molina Healthcare - Doral, FL

Job Description Job Summary Molina 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 desi...

Supv, Healthcare Services

Molina Healthcare - Doral, FL

Job Description Job Summary Works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. Assesses members for care needs, and develops treatment plan with practitioners, providers, members and support system. Ensures quality member care is provided. Ensures patient is progressing towa...

Case Manager, LTSS

Molina Healthcare - Oak Brook, IL

Job Description Job Summary Molina 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 desi...

Clinical Services Auditor (RN)

Molina Healthcare - Midvale, UT

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). • Monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May also perform non-clinical system and p...

Case Manager (RN)

Molina Healthcare - Irving, TX

Job Description Job Summary Molina 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 desi...

Auditor, Member Appeals & Grievances

Molina Healthcare - Columbus, OH

Job Description Job Summary Molina Health Plan Operations jobs are responsible for the development and administration of our State health plan's operational departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provid...

Case Manager (RN)

Molina Healthcare - Houston, TX

Job Description Job Summary Molina 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 desi...

Account Rep, Medicare (Remote)

Molina Healthcare - San Bernardino, CA

Job Description Job Summary Responsible 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. ...

Case Manager BH (Behaviroal Health)

Molina Healthcare - Champaign, IL

Job Description Job Summary Molina 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 desi...

Specialist, Delegation Oversight

Molina Healthcare - Jackson, MS

Job Description Job Summary Responsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with DMHC and DHCS requirements including delegation standards and requirements contained in the Molina Medical Compliance and Fraud, Waste and Abuse Program. Knowledge/Skills/...

Manager, Financial Planning & Analysis

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for developing the organization's short- and long-term financial plans and identifying financial opportunities to improve the organization's profitability Knowledge/Skills/Abilities • Manages timely submission of analytics and reports required for the FP&A function • Responsible for ensuring the integrity ...

Nurse Practitioner, Field (Jackson, MS)

Molina Healthcare - Columbus, OH

Job Description Job Summary The Care Connections NPs focus on screening and preventive primary care services delivered in the home, community and nursing facility settings. As a clinician, you will have the rewarding experience of providing needed care in the environment that patients feel most comfortable and are most receptive including home, nursing facilities, ...