Jobs at Molina Healthcare - Page 11

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Displaying results 151 - 165 of 310

Care Review Clinician, Inpatient Review (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...

HR Business Partner

Molina Healthcare - Doral, FL

Job DescriptionJob SummaryResponsible for building relationships with employees at all levels of the organization while supporting their Human Resources (HR) needs. Performs HR related duties in some or all of the following functional areas: employment & talent acquisition, employee relations, new employee orientation & training, workplace compliance, ...

Provider Contracts Manager Behavioral Health

Molina Healthcare - Bothell, WA

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...

Director, Provider Services

Molina Healthcare - Long Beach, CA

Job SummaryBring your strong provider relationship development and provider training & education to this leadership role within our California health plan. What you will do:• Provide and develop standards and resources to help the Molina health plan successfully develop and refine cost effective and high quality strategic provider networks, establishing b...

Director, Provider Contracts

Molina Healthcare - Long Beach, CA

Summary Bring your Medical & Medicare contracting management experience to our California health plan. Lead the contracting group handling LA, Orange County & Inland Empire areas. What you will do:Plan, organize, staff, and coordinate the Provider Contracts activities for the state health plan. Work with direct management, senior leadership/management, Cor...

Medical Director, Health Plan

Molina Healthcare - Oak Brook, IL

Job Summary Bring your physician leadership and utilization review/management experience to our Medical Director role in the Illinois health plan. Solid performance in UM/UR arena may lead to project work in population health and affecting health outcomes for tens of thousands of members. What you will do:Provide medical oversight and expertise in ...

Adjuster, Claims Medicare and Healthcare

Molina Healthcare - Long Beach, CA

Claims Adjustments - knowledge of healthcare and managed care claims processes, review, correction. Medicare knowledge and experience a plus Job SummaryResponsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog ...

Director, Provider Contracts

Molina Healthcare - San Diego, CA

Summary Bring your Medical & Medicare contracting management experience to our California health plan. Lead the contracting group handling San Diego, Imperial Valley & Sacramento areas. What you will do: Plan, organize, staff, and coordinate the Provider Contracts activities for the state health plan. Work with direct management, senior leadership/...

Assoc Specialist, Provider Contracts

Molina Healthcare - Irving, TX

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 ...

Analyst, Healthcare

Molina Healthcare - Midvale, UT

Job Description Job 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.Molina Healthcare Core Com...

RN Transition of Care Coach (Field: Whatcom County, WA)

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...

Sourcing Manager

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for all aspects of purchasing goods and services required by the business, and collaborates with suppliers to determine price and purchasing schedule.Knowledge/Skills/Abilities• Collaborate with relevant businesses as a procurement partner to solidify Molina's competitive advantage• Develop d...

Mgr, Member Services

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryProvides 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 rela...

Sr Analyst, Data (SQL)

Molina Healthcare - Long Beach, CA

This position daily utilizes SQL Job SummaryDesigns and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and u...

Provider Contracts Spc

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryProvides contracting expertise in the realm of providers.Knowledge/Skills/Abilities• Responsible for the negotiation of contracts and letters of agreements with hospitals, physician groups and ancillary providers that result in high quality, cost effective and marketable providers.• Initiates, negotiates...