Jobs at Molina Healthcare - Page 2

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Mgr, Healthcare Services

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...

Transition of Care Coach (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...

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...

Analyst, Healthcare Analytics

Molina Healthcare - Syracuse, NY

Job Description Job Summary The 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 findings. ...

Specialist, Quality Interventions/QI Compliance

Molina Healthcare - Syracuse, NY

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...

Program Manager

Molina Healthcare - Midvale, UT

Job Description Job Summary Manages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and ...

Sr Specialist, HEDIS/ Quality Reporting

Molina Healthcare - Bothell, WA

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...

Sr Specialist, Delegation Oversight - (Claims Auditor)

Molina Healthcare - Long Beach, CA

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...

Auditor, Appeals & Grievances

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina Healthcare's Appeals & Grievances jobs are responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid. Knowledge/Skills/Abilities • Conducts aud...

Program Director

Molina Healthcare - Long Beach, CA

Job Description Job Summary Manages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and ...

Assoc Analyst, Config Info Mgm

Molina Healthcare - Boise, ID

Job Description Job Summary Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adhe...

Architect, MITA Business

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for all PeopleSoft, Kronos and ESS functions, determining staffing needs, hiring and mentoring staff members, annual reviews, and managing day-to-day allocation of activities for the team and preparing reports to Sr Management levels. Knowledge/Skills/Abilities • Provides advanced leadership and solution desig...

Admin, IT Systems

Molina Healthcare - Boise, ID

Job Description Job Summary Troubleshoots hardware and software problems, assists users with desktop applications and provides user training. Utilizes applications such as Altiris to track user requests from trouble-ticket generation through problem resolution. Escalates a problem to other network or system support personnel when the problem is not easily identified...

Sr Business Relationship Mgr,

Molina Healthcare - Irving, TX

Job Description Job Summary Responsible for leveraging the technology for the benefit of the business. Interface and manage strategic relationships with business partners by representing & promoting IM capabilities Knowledge/Skills/Abilities Manages and provides direct oversight of all health plan IT activities, by providing process expertise, manag...

Lead, HCS Central Programs (Non-Clinical)

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina Healthcare Services (HCS) Central Programs Department 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 Central Programs staff work ...