Jobs at Molina Healthcare - Page 7

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Sr Generalist, Medicare Administration

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryResponsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic ...

Supv, Care Management

Molina Healthcare - Albuquerque, NM

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...

RN Case Manager East Metro - Remote

Molina Healthcare - East St Louis, IL

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...

Quality Associate Specialist

Molina Healthcare - Syracuse, NY

Job DescriptionJob Summary The Quality Associate Specialist, could be a contributor to one or more critical Quality functions. These functions include,but may not be limited to, Quality Reporting, Performance Measurement Operations, Interventions, Quality Improvement Compliance, and Quality Outreach. You will be responsible for planning, developing and directi...

Specialist, Quality Interventions/ QI Compliance

Molina Healthcare - Doral, FL

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 measuremen...

Associate Specialist, Provider Contracts

Molina Healthcare - Jackson, MS

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...

Business Analyst

Molina Healthcare - Jackson, MS

Job DescriptionJob SummaryAnalyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Crea...

Manager, Provider Contracts

Molina Healthcare - Jackson, MS

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...

Sr. Provider Contracts Specialist (2 positions)

Molina Healthcare - Jackson, MS

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

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/...

Sr Rep, Provider Services (MMS)

Molina Healthcare - Boise, ID

JOB DESCRIPTION: Responsible to create and maintain professional relationships within the medical provider community. Develop, maintain and deliver education materials to providers, Associations, internal and contract management staff in group and individual settings. Educate, investigate, respond and document inquiries from the provider community and State partners within...

Sr Rep, Provider Services (MMS)

Molina Healthcare - Boise, ID

Job DescriptionJOB DESCRIPTION: Responsible to create and maintain professional relationships within the medical provider community. Develop, maintain and deliver education materials to providers, Associations, internal and contract management staff in group and individual settings. Educate, investigate, respond and document inquiries from the provider communit...

Care Review Processor-Maternal Child Unit

Molina Healthcare - Columbus, OH

Job DescriptionOhio Plan Specific: This role would be the administrative support to the Maternal Child Mortality Case Management Team. Their entire focus is the health of Mothers and Infants. You would help with the record keeping as it relates to measurements required for Medicaid, ie: Progesterone usage by members. This is one of the dedicated teams who guide the healt...

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 ...

Operational Excellence Process Consultant

Molina Healthcare - Bothell, WA

Job DescriptionJob SummaryLeads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of Molina Healthcare of Washington business process improvement and in the implementation of a business process improvement capability utilizing Lean methodology....