Jobs at Molina Healthcare - Page 9

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Rep, Pharmacy (Pharmacy Tech Certification Required)

Molina Healthcare - San Juan, Puerto Rico

Job DescriptionJob SummaryMolina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal a...

RN Case Manager - REMOTE - Collier County, Illinois

Molina Healthcare - Oak Brook, 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...

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...

Sr Analyst, Business

Molina Healthcare - Albuquerque, NM

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. Creat...

Pharmacy Technician

Molina Healthcare - San Juan, Puerto Rico

Job DescriptionJob SummaryMolina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal a...

Case Manager (RN)

Molina Healthcare - Irving, 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 ...

Pharmacist, Clinical/MTM

Molina Healthcare - Columbus, OH

Job DescriptionJob SummaryMolina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with a...

Actuarial Analyst

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryResponsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks.Knowledge/Skills/Abilities• Collaborate with Actuarial staff to perform IBNR estimates and rate adequacy studies. Document assumptions.

Receptionist

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryProvides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. May also perform a variety of activities in support of the functional processes, programs and/or services. Also provides the administration of various programs, ...

Director, Appeals & Grievances

Molina Healthcare - Irving, TX

Job DescriptionJob SummaryResponsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is 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 Medicai...

Clinical Appeals Nurse (RN)

Molina Healthcare - San Antonio, TX

Job DescriptionJob SummaryClinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance standards.Knowledge/Skills/Abilities• The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals request has been made or upon request b...

Assoc Project Manager

Molina Healthcare - Long Beach, CA

Job DescriptionJob SummaryThe Associate Project Manager will manage 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...

CMS Program Director, Regulatory Compliance

Molina Healthcare - Long Beach, CA

Office Location: Long Beach, CA Relocation Assistance Available Responsible for acting as a liaison between CMS / State agencies and Molina business units. Works with members, providers, federal and state agencies, and multidisciplinary teams to assess, plan and coordinate an integrated delivery of health care across the continuum of care. As Molina expands its ope...

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...