Jobs at Molina Healthcare

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Rep, Provider Inquiry R&R

Molina Healthcare - Syracuse, NY

Job Description Job Summary Molina Health Plan Operations jobs are responsible for the development and administration of our State health plan's operational departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provide...

Assoc Specialist, Appeals & Grievances

Molina Healthcare - Syracuse, NY

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 • Enters denia...

Care Review Clinician, Social Worker

Molina Healthcare - Syracuse, NY

Job Description We are excited to Celebrate Molina Healthcare in the New York Market for the several years. Word is spreading and our membership is expanding and becoming more robust. We are excited to expand our Services. This role in New York is part of a larger Medicaid Behavioral Health role out under the HARP program. The main purpose is traditional Utilization M...

Executive Office Manager, Administrative Services

Molina Healthcare - New York, NY

Job Description Job Summary Molina Healthcare Inc. is expanding our corporate operations with a brand-new office in Manhattan, NY. For the right person, this is a tremendous opportunity to help a Fortune 200 Company establish its New York City footprint. In this role you will manage all office administrative functions while working directly with ou...

Sr Specialist, Provider Network Admin

Molina Healthcare - Syracuse, NY

Job Description Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts....

Case Manager (RN) FIELD REMOTE

Molina Healthcare - Syracuse, NY

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...

Financial Analyst

Molina Healthcare - Syracuse, NY

Job Description Job Summary Responsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial projects or programs. Duties include gathering, interpreting, and evaluating financial information; generating forecasts and analy...

Specialist, Community Engagement (FIELD MARKETING REP - Broome County)

Molina Healthcare - Cortland, NY

Job Description Job Summary Responsible 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...

Specialist, Community Engagement (FIELD MARKETING REP - Broome County)

Molina Healthcare - Cortland, NY

Job Description Job Summary Responsible 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...

Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - Syracuse, NY

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...

Nurse Practitioner: Field /Syracuse, NY (Onondaga County)

Molina Healthcare - Syracuse, NY

Job Description Job Summary Molina Healthcare has always been a special place to work. Founded by Dr. C. David Molina 35 years ago, the company has grown over the past few decades from a single clinic to health plans serving fifteen states. During the time of expansion we have never lost sight of the mission that defines us; to serve the most financially vuln...

Case Manager - Behavioral Health

Molina Healthcare - Syracuse, NY

Job Description New York Plan Specific. The contract with the New York plans requires for this role to be have what is listed below. This role cannot be staffed with a Registered Nurse. Minimum of Associates Degree or Advanced Degree in Behavioral Health field, example a LMHC or LMSW This license needs to be unrestricted license to practice ...

Case Manager (RN) FIELD REMOTE

Molina Healthcare - Syracuse, NY

Job Description The State of New York Contract requires that this role be filled with a Registered Nurse with an unrestricted license in the state of New York. Remote for this role means field based or community based. Once a month meeting in office minimum. Rest of time is member visits at provider offices and/or home and documentation at home. Ratio of t...

Senior Analyst, Healthcare Analytics (Syracuse or Columbus)

Molina Healthcare - Syracuse, NY

Job Description Job Summary Performs 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. SQL knowledge and daily working with de...

Nurse Practitioner: Field /Syracuse, NY (Onondaga County)

Molina Healthcare - Syracuse, NY

Job Description Job Summary Molina Healthcare has always been a special place to work. Founded by Dr. C. David Molina 35 years ago, the company has grown over the past few decades from a single clinic to health plans serving fifteen states. During the time of expansion we have never lost sight of the mission that defines us; to serve the most financially vuln...