Jobs at Molina Healthcare - Page 4

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Correspondence Processor

Molina Healthcare - Troy, MI

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 ...

Case Manager (RN/LSW) Long Term Services and Support

Molina Healthcare - Cincinnati, 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 ...

Operational Excellence Process Consultant: Lean Certified / Six Sigma Black Belt

Molina Healthcare - Midvale, UT

Job DescriptionJob SummaryLeads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of MHU's business process improvement methodology and in the implementation of a business process improvement capability.Knowledge/Skills/Abilities• Respo...

Associate, Risk Adjustment

Molina Healthcare - Albuquerque, NM

Job DescriptionJob SummaryRisk Adjustment is responsible for quality measurement and process improvement in the application of regulatory requirements.Knowledge/Skills/Abilities• Helps support day to day operations• Helps under supervision to support Risk Adjustment related projects, including goals, objectives, milestones and de...

RN - Clinical Services Trainer - Remote - Mississippi

Molina Healthcare - Long Beach, CA

Knowledge/Skills/AbilitiesProvides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state and federal regulations and guidelines. Responsible for the development and implementation of training curriculum for Utilization Management, Case Management, and LTSS staff.• Responsible for evaluation of trai...

Sr. Abstractor, HEDIS/Quality Improvement

Molina Healthcare - Bothell, WA

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/...

LSW - Clinical Services Trainer - Remote

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities• Provides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state and federal regulations and guidelines. • Responsible for the development and implementation of training curriculum for Utilization Management, Case Management, and LTSS staff.• Responsible for evaluation of ...

RN Clinical Services Trainer - Remote

Molina Healthcare - Long Beach, CA

Knowledge/Skills/AbilitiesProvides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state and federal regulations and guidelines. Responsible for the development and implementation of training curriculum for Utilization Management, Case Management, and LTSS staff.• Responsible for evaluation of trai...

LSW Clinical Services Trainer - Remote

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities• Provides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state and federal regulations and guidelines. • Responsible for the development and implementation of training curriculum for Utilization Management, Case Management, and LTSS staff.• Responsible for evaluation of ...

Executive Assistant

Molina Healthcare - Sacramento, CA

Job DescriptionJob SummaryProvides administrative level support to management and/or division team members. Prioritizes management/client requests in order to meet business objectives. Supports the day-to-day administrative operations of a department and/or site.Knowledge/Skills/Abilities• Composes and types routine memos and correspondence ...

Sr Rep, Provider Services

Molina Healthcare - Syracuse, NY

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. Provi...

Administrative Assistant

Molina Healthcare - Milwaukee, WI

Job Description Job SummaryProvides administrative level support to management and/or division team members support such as answer and forward calls, file management, ordering office supplies and processing of incoming and outgoing mail. May also perform a variety of functions in support of the health plan as needed by various departments. May also be re...

Provider Contracting Manager

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryNegotiates agreements with highly visible providers who are strategic to the success of the Plan, including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers.Knowledge/Skills/Abilities• In conjunction with Director/Manager Provide...

Lead, Core Ops

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible 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.Kn...

Analyst, Provider Configuratio

Molina Healthcare - Columbus, OH

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 ...