Jobs at Molina Healthcare - Page 11

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Specialist, Delegation Oversight

Molina Healthcare - Oak Brook, IL

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/A...

Bilingual Call Center Reps (Multiple Openings)

Molina Healthcare - Irving, TX

Job Description Job Summary Provides 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. R...

Mgr, Healthcare Services

Molina Healthcare - Syracuse, NY

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 desir...

Case Manager/Care Coordinator (RN)-Midlands/Columbia

Molina Healthcare - North Charleston, SC

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 desir...

Case Manager, LTSS (RN or Licensed Social Worker)

Molina Healthcare - Troy, MI

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 desir...

Supervisor, Accounting

Molina Healthcare - Irving, TX

Job Description Job Summary Use of general accounting principles and rules to create financial reports and analysis. Duties include all aspects of the Accounting function, such as, control of accounts and records, recording of transactions, analysis of financial data, preparation budgets, forecasts, financial statements and accounting schedules/reports, and auditing...

Care Review Clinician, Inpatient Review (RN) (Remote)

Molina Healthcare - Long Beach, CA

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 desir...

Care Review Clinician, Inpatient Review (BH)

Molina Healthcare - Bothell, WA

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 desir...

Analyst, HEDIS/ Quality Reporting - SQL Developer

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina'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...

Specialist, Claims Recovery - Healthcare

Molina Healthcare - Spokane, WA

Job Description Job Summary Responsible 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...

Assoc Analyst, Provider Config

Molina Healthcare - Midvale, UT

Job Description Job Summary Responsible 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 be housed on...

Analyst, Coding

Molina Healthcare - Troy, MI

Job Description Job Summary Establish 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 Health Care...

VP, Network Mgmt & Ops

Molina Healthcare - Jackson, MS

Job Description Job Summary Molina Health Plan Operational Leadership roles provide overall direction and administration of the Plan's operational departments, programs and services. Responsibilities include: implementing programs that are in alignment with Molina Healthcare's strategic and operating plan; providing day-to-day leadership and management of th...

HR Business Partner Manager

Molina Healthcare - Columbus, OH

Job Description Job Summary Provides 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 comprehensive suppo...

Case Manager (RN)

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 desir...