Molina Healthcare of Nevada is seeking a dynamic Community Outreach, Growth & Engagement Specialist in/near the Clark County area.This role will help drive choice membership and retain existing members. This......
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 SummaryResponsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Pla...
JOB DESCRIPTIONJob 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, ...
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Job DescriptionJob SummaryEnsures the health plan meets its Community Reinvestment obligations under the Medicaid and HIDE SNP contracts while supporting the needs of the communities served across its footprint. Leads......
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 SummaryProvides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions, and complaints. Resolves member inquiries and complaints fairly a...
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JOB DESCRIPTIONJob SummaryThe Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the envir...
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 DESCRIPTIONOpportunity for a degreed, experienced Case Manager to join Molina as a Field Case Manager. Candidates with Waiver Population will be given priority. Responsibilities for this role includes conducting......
JOB DESCRIPTIONPartnership 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 Senior HRIS Analyst is responsible for technical operations of Oracle HCM Cloud system including data analysis and reporting, system administration, and project management. This role helps pr...
Job DescriptionJob OverviewThe Associate Vice President of Call Center Operations plays a critical role in managing and optimizing call center operations, with a focus on supporting Medicare-related services. As an......
Job Description Job SummaryThe Social and Health Equity Navigator will assist members in addressing social conditions that impact health outcomes, assist with the development of a process to collect, analyze,......
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...
Opportunity for a Telephonic RN to join our Marketplace Team performing telephonic Case Management. 100% remote. Schedule is M F, 8AM -5PM PST, and flexibility with schedule is necessary, as......
Job SummaryAs a member of the Customer Experience team, the Director, Data Analytics ensures timely creation of key Executive and Health plan management reports, as well as providing critical analytical......
JOB DESCRIPTIONJob SummaryThe Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the envir...
JOB DESCRIPTIONJob SummaryThe Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the envir...
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 SummaryResponsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Pla...
***The candidates must reside in CA*****JOB DESCRIPTION Job Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and......
JOB DESCRIPTIONJob SummaryThe Marketplace Facilitated Enroller (MFE) is responsible for identifying prospective members that do not have health insurance and assisting with the enrollment process ultimately making it easi...
INPATIENT REVIEW : REGISTERED NURSEFor this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge......
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 SummaryThe Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the appropriate resolution of claims issues. This ...
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...
Molina Healthcare of Texas is hiring for an RN Trainer, Clinical Services in Texas. This role is remote, however candidates must live in Texas.Creates and delivers clinical training programs for......
***Remote and must live in the Albuquerque area***Job DescriptionJob SummaryMolina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial...
Washington, District of Columbia
5 days
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 SummaryProvides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. May also perform...
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......
POPULATION / PUBLIC HEALTH NURSE CASE MANAGERWe are looking for a Case Manager who must reside and be able to drive within CLARK COUNTY NEVADAMust have experience with chronic conditions......
JOB DESCRIPTIONJob SummaryResponsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to pro...
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 within M...
EMERGENCY ROOM ADMISSIONS REVIEW NURSEPERMANENT SHIFT WILL BE :12 hour NIGHT SHIFT:7:30PM (in the evening) - 08:30AM (in the morning) PACIFIC HOURS NON EXEMPT, 3 days a week will rotate.This......
Charleston, South Carolina
3 days
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 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 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 SummaryAre you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then youll......
JOB DESCRIPTION****This position is remote but employee must reside in Michigan****Job SummaryWorks in partnership with Delegation Oversight, Provider Network, and Operations to manage day to day operational issues for de...
KNOWLEDGE/SKILLS/ABILITIESPlans, organizes, staffs, and coordinates the Provider Contracts activities for contracts at a National Level. Works with direct management, senior leadership/management, Corporate, and staff to ...
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 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...
*** The candidate must be able to work PST hours.******The IT Sr. Systems Analyst is responsible for the analysis, design, and implementation of IT Healthcare Compliance & regulatory systems to......
JOB DESCRIPTIONJob Summary Responsible for accurate and timely production review of issues reported within our claims intake and processing ecosystem (QNXT, Edifecs, etc.). Gains understanding of solution functionality t...
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......
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 SummaryTMG is on the lookout for our next great Eligibility Screener! If you love doing meaningful work that helps others live their best lives, we want to hear......
JOB DESCRIPTIONJob SummaryMolina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the compan...
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...
JOB DESCRIPTIONJob SummaryThe Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the envir...
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......
JOB DESCRIPTION Job Summary Designs 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......
KNOWLEDGE/SKILLS/ABILITIESDevelop and deploy workforce management strategies nationwide. Partner with leaders to identify business and propose solutions in line with the needs of our members and providers. Requires contac...
JOB DESCRIPTIONWe are seeking RN (Registered Nurse), who must live in the CINCINNATI OHIO area, and must be licensed for the state of OHIO. Excellent computer skills and attention to......
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 SummaryThe Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the envir...
JOB DESCRIPTIONJob SummaryResponsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Pla...
Charleston, South Carolina
12 days
JOB DESCRIPTIONFor this position we are seeking a (RN) Registered Nurse who lives in South Carolina and must be licensed for the state of South Carolina.Supervisor will support Case Managers......
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 Care Connections Representative primary focus is to conduct outbound calls to Molina members and schedule appointments with our Nurse Practitioners. As part of Molina's benefit package, the.....
JOB DESCRIPTIONJob SummaryFor this position we are seeking a Community Connector to provide support for the Medicaid population for the Michigan Health Plan. Excellent computer skills (Microsoft Office) and attention......
JOB DESCRIPTIONJob SummaryThe Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the envir...
JOB DESCRIPTIONJob SummaryCollects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to other end users for op...
Molina Healthcareis hiring a Manager of Growth and Community Engagement in the Riverside or San Bernardino area.For over 40 years, Molina Healthcare has been a purpose-driven company committed to improving......
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 DESCRIPTIONOpportunity for Social Worker to provide Case Management services to our Medicaid members in the Dallas Service Delivery Area. Applicants must hold either a LBSW or LMSW in the......
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 SummaryDesigns, 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 key pri...
We are seekingaRN (Registered Nurse) Case Manager for Washoe County, NEVADA. Qualified candidate must currently live in Washoe County. Excellent computer skills and attention to detail are very important to......
JOB DESCRIPTIONJob SummaryThe Business Control Process Design and Implementation Senior, under the direction of Mgr, IT Controls and ERM, is responsible for developing a risk based process design approach for......
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 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......
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......
Job Description Job SummaryThe Auditor, Eligibility Screening is responsible for providing support to the TMG IRIS Consultant Agency (ICA) Long Term Care Functional Screening team with processes and coordinating activiti...
Job SummaryMolina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs specific to the Provider Network; ensures maintenance of ...
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 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 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 DescriptionJob SummaryThe Program Director, Marketplace Contracting is responsible for managing the Marketplace provider contracting process for the assigned regions. Leads the Marketplaces provider strategy, while de...
JOB DESCRIPTIONJob SummaryThis position is a project management role focused on supporting provider data solution and processes. Contributing to accurate and timely maintenance of critical provider information on all clai...
***Remote and must live in Nebraska***Job DescriptionJob SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignmen...
For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.......
Job DescriptionJob SummaryResponsible for the development and maintenance of an effective and efficient broker channel for assigned geographical region. Work in collaboration with other Broker Channel Managers, Field Sale...
For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.......
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......
JOB DESCRIPTIONJob SummaryResponsible for achieving established goals improving Molinas enrollment growth objectives encompassing Medicaid programs. Works collaboratively with key departments across the enterprise to impr...
Job DescriptionJob SummaryResponsible for work load assignment to the provider Claims adjudicators and senior provider claims adjudicators. Train and coach new employees. Provide clear and concise results on the provider....
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...
JOB DESCRIPTIONJob SummaryThe Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the envir...
JOB DESCRIPTIONJob SummaryResponsible for the Management of internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process ...
***Remote and must live in California***Job DescriptionJob SummaryMolina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performan...
JOB DESCRIPTIONJob SummaryThe Marketplace Facilitated Enroller (MFE) is responsible for identifying prospective members that do not have health insurance and assisting with the enrollment process ultimately making it easi...
***Remote and must live in Michigan***Job DescriptionJob SummaryMolina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance...
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 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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