Jobs at Molina Healthcare - Page 6

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Utilization Management Prior Authorization LVN/LPN

Molina Healthcare - Long Beach, CA

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 toward desire...

Sr Specialist, Quality Interventions/QI Compliance

Molina Healthcare - North Charleston, SC

Job DescriptionJob SummaryMolina'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...

Clinical Services Trainer (LVN) Utilization Management

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryCompletion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program and/or Associate's or Bachelor's Degree in Health related field.Knowledge/Skills/AbilitiesProvides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state...

Care Review Clinician, Prior Authorization (Nurse, RN or LPN)

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 toward desir...

Care Review Processor

Molina Healthcare - San Antonio, TX

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 toward desir...

Registered Nurse Care Review Clinician, Inpatient Review

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 ...

RN, LVN, MSW - Case Manager

Molina Healthcare - Doral, FL

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 ...

Tech, Service Desk

Molina Healthcare - San Juan, Puerto Rico

Job DescriptionJob SummaryPerforms the installation, repair and preventative maintenance of desktop/laptop computer and related systems. Assists in determining suitable software to meet user requirements. Troubleshoots software and hardware failures and identifies network problems when they relate to desktop or laptop computers and other networking devices. Provid...

Sr Corporate Recruiter

Molina Healthcare - San Juan, Puerto Rico

Job DescriptionJob SummaryDevelops and implements staffing strategies including development of sourcing approaches, interview and selection processes, university recruitment programs and company branding.Knowledge/Skills/Abilities• Writes complete and detailed search assignments, ensuring an understanding of the job duties, responsibilities, and...

Lead, Healthcare Claims

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...

Pharmacy Service Rep

Molina Healthcare - Charleston, WV

Job DescriptionJob SummaryHandles provider phone calls regarding pharmacy claims processing in a call center setting. Satisfactorily resolve calls within expected response time standards.Knowledge/Skills/Abilities• Handles inbound pharmacy call volume.• Responds to incoming calls mainly from providers, as required to meet departm...

Director, Compliance

Molina Healthcare - Midvale, UT

Job DescriptionJob SummaryEstablish 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...

Correspondence Processor

Molina Healthcare - San Antonio, TX

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 ...

Specialist, Community Engagmnt

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryResponsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages.Knowledge/Skills/Abilities• Under limited supervision, responsible fo...

LSW Case Manager Community Based

Molina Healthcare - Syracuse, NY

Job DescriptionNew York Plan Specific: This role requires a Licensed in the State of New York Social Worker who will be caring a Case Load of members and responding to their social needs along with the Registered Nurse Case Managers and Transition of Care Nurses. It is a team approach. This position is remote in the field. You would only need to attend occasional meeting...