Job DescriptionJob SummaryResponsible for the development of marketing and sales collateral aimed at brand and message management. Develops, implements, and manages content for campaigns and other growth initiatives. Know...
JOB DESCRIPTIONJob SummaryDesigns and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gai...
JOB DESCRIPTIONJob SummaryFocuses on process improvement, organizational change management, project management and other processes relative to the business. Project management includes estimating, scheduling, costing, pla...
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, i...
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JOB DESCRIPTIONJob SummaryResponsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the p...
JOB DESCRIPTIONJob SummaryResponsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operati...
JOB DESCRIPTIONJob SummaryThe Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care...
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For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines. COMPACT......
We are looking for a RN Care Transitions Case Manager who must reside in CALIFORNIA and be able to drive within one of the following county locations: Los Angeles County,......
For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN......
JOB DESCRIPTIONJob SummaryAnalyzes and determines training needs and problems. Develops, administers, and implements all training programs in accordance with the Business' initiatives and strategies. Conducts special cour...
JOB DESCRIPTIONJob SummaryResponsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated ...
Job Description Job Summary Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: Appeals an...
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, i...
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, i...
For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines. COMPACT......
Job SummaryThe Dir, Marketing & Creative Services is responsible for managing and maintaining Marketing Operations for Molina Healthcare, while driving to deliver operational excellence with the effective and efficien...
Job Description Job SummaryThe Lead, Risk Adjustment - Predictive Analytics role supports Molina's Risk Adjustment Predictive Analytics team. Designs and develops Suspect, Targeting, and Tracking System to support Molinas...
JOB DESCRIPTIONJob SummaryMolina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical dependency services and assists with im...
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, i...
JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSEFor this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review /......
Job Description Job Summary Responsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Knowledg...
JOB DESCRIPTIONJob SummaryMolina Health Plan Operational Leadership roles provide overall direction and administration of the Plan's operational departments, programs, and services.Responsibilities include implementing pr...
Job Description Job Summary Establish a specifically designed Operational Regulatory Oversight program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Busines...
Job Description Job SummaryThorough knowledge of processing professional, outpatient facility, and inpatient facility claims for Medicare, Medicaid, and Marketplace plans. Assists Molina departments with reviewing and con...
JOB DESCRIPTIONJob SummaryDo you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people......
For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines. COMPACT......
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, i...
For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN......
JOB DESCRIPTIONJob SummaryThe Senior HRIS Analyst is responsible for assisting with the day-to-day technical operations of UKG/Kronos Dimensions system including data analysis and reporting, system administration, and esc...
Job DescriptionJob SummaryMolina Health Plan Operations jobs are responsible for the development and administration of State Health Plan's operational departments, programs and services, in alignment with Molina Healthcar...
Job DescriptionJob SummaryResponsible for supervising day to day operations within the Broker Services Unit (BSU) for Medicare and Marketplace product lines, including, but not limited to, general workforce management, ha...
JOB DESCRIPTIONJob SummaryProvider 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...
Job DescriptionJob SummaryAs a product subject matter expert, the AVP is a strategic thought partner and leader in the successful development and implementation of new programs and initiatives in collaboration......
Job Description****This role will work EST business hours****Job SummaryMolina's HEDIS/Quality Improvement Sr. Medical Records Collector is a team member with several years experience in working collaboratively with outre...
JOB DESCRIPTIONJob SummaryMolina's HEDIS/Quality Improvement Medical Records Collector will work collaboratively in outreaching to providers in order to pursue medical records via phone call, fax, mail, electronic medical...
JOB DESCRIPTIONJob SummaryResponsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the p...
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, i...
JOB DESCRIPTIONFamily Care with My Choice WisconsinJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated deli...
JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSEFor this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review /......
JOB DESCRIPTIONFamily Care with My Choice WisconsinJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated deli...
Job DescriptionJob SummaryThe Director, Clinical Data Acquisition is responsible for the implementation, monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment, Risk Adjustmen...
For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN......
JOB DESCRIPTIONJob SummaryMolina Healthcare Services (HCS) is required by CMS and state agencies to coordinate benefits when other carriers are responsible for payment. This requires the maintenance of other insurance......
Job Description Job SummaryMolina's Quality Improvement Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The lead abstra...
Job Description Job Summary Designs and builds company specific enterprise application systems and technology expertise across multiple disciplines. Applies and promotes key principles (e.g. stability, scalability, perfo...
Bilingual Required: Mandarin, Cantonese, Vietnamese, Tagalog, or French Shift: 7:30 am 4pm PST= 8:30 am 5:00pm MST = 9:30am 6:00pm CST= 10:30am 7:00pmEST Required License: Active and unrestricted Life and......
JOB DESCRIPTIONJob SummaryMust be able to work in EST hours.Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims database...
Job Description Job Summary Designs, develops, and communicates technology models and foundations used to run applications, data, and infrastructure in support of one or more business processes. Applies and promotes......
JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSESPECIALIST IN PEDIATRICS CLINICAL UTILIZATION MANAGEMENT REVIEWSFor this position we are seeking a (RN) Registered Nurse with previous experience in Acut...
JOB DESCRIPTIONJob SummaryAnalyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Participates in LTSS system design and improvement processes. Id...
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, i...
JOB DESCRIPTIONJob SummaryMolina's HEDIS/Quality Improvement Medical Records Collector will work collaboratively in outreaching to providers in order to pursue medical records via phone call, fax, mail, electronic medical...
JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW BEHAVIORAL HEALTH : REGISTERED NURSE (2 openings)For this position we are seeking a (RN) Registered Nurse with previous experience in Behavioral Health Acute......
Job Description Job SummaryMolina's Quality Improvement Sr. Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction...
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 loc...
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 membe...
JOB DESCRIPTIONFor this position, Enrollment experience is a must have. Ideal candidate will have experience working at an MCO onthe Enrollment operations team or at a health plan.Experience with 834......
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, i...
Job DescriptionJob SummaryThe Clinical Correspondence Review Nurse is responsible for performing quality reviews of written clinical determination letters to members and providers to ensure clinical determination letters ...
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 an...
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,...
Job Description Job Summary Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: Appeals an...
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, i...
For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines. COMPACT......
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, i...
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, i...
JOB DESCRIPTIONFor this position, Enrollment experience is a must have. Ideal candidate will have experience working at an MCO onthe Enrollment operations team or at a health plan.Experience with 834......
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, i...
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 membe...
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 membe...
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, i...
For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines. COMPACT......
Job DescriptionJob SummaryResponsible for comprehensive end to end claim audits. This includes; administering audits related to accurate and timely implementation and maintenance of critical information on all claims and ...
Job DescriptionJob SummaryResponsible for continuous quality improvements regarding member engagement and memberretention. Represents Member issues in areas involving member impact and engagement including:New Member Onbo...
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......
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