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 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 DESCRIPTIONFamily Care with My Choice Wisconsin - must reside in WIJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinat...
JOB DESCRIPTIONFor this position we are seeking a (RN) Registered Nurse who lives in VIRGINIA and must be licensed for the state of VIRGINIA.Case Manager will work in remote and......
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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 Description Job Summary The FWA Analyst, SIU works with health plans and operations departments to assess, oversee, and recommend business practices to ensure adherence to and compliance with State......
Job DescriptionJob SummaryThe SIU Senior Investigator position is primarily responsible for supporting the day to day operations and initiatives of the Special Investigations Unit (SIU). Knowledge/Skills/Abilities Respond...
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...
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 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 Analyst, Encounters is responsible for monitoring inbound and outbound encounters processes and ensuring timely, accurate, and complete encounter submissions for low- to moderate-complexity m...
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...
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,......
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......
INPATIENT REVIEW : REGISTERED NURSEFor this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge 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 DESCRIPTIONFor this position we are seeking a (RN) Registered Nurse residing and licensed in state of Ohio.Case Manager will work in remote and field setting supporting Ohio plan supporting......
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 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 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...
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 ...
***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 Clinical Formulary Pharmacist works to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner.......
FIELD RN OR CASE MANAGER - PUBLIC HEALTHWe are looking for a Case Manager who must reside and be able to drive within CLARK COUNTY NEVADAMust have experience with Public......
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...
JOB DESCRIPTIONFor this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside in. Strong medical and hospital analytical experience is needed. Excellent......
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 DESCRIPTIONCandidate must reside in CA *****Job SummaryProvider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider ...
*** 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 SummaryMolina Medicare Stars Program Manager functions oversees, plans and implements new and existing health care quality improvement initiatives and education programs. Responsible for Medicare Stars ...
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 Description Job SummaryResponsible for conducting various audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure accuracy in auditing......
***Remote and must live in Utah***Job DescriptionJob SummaryMolina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and...
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 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 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......
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......
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'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 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 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 Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider communications, training and education, in alignment with...
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 DescriptionJob SummaryMolina Healthcare of OH is seeking a Sr. Clinical Project Manager with experience in project management, business analysis, healthcare industry, and nursing work. The Clinical Sr. Project Manager...
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 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...
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...
Charleston, South Carolina
5 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 DESCRIPTIONFor this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside in.This role will be doing prior authorization outpatient request for......
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......
Greenville, South Carolina
4 days
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 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 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 ...
***Remote and must live in the United States***JOB DESCRIPTIONJob SummaryResponsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider i...
Job Description Job SummaryMolina Healthcare Services (HCS) Department works with members, providers, and multidisciplinary team members to assess, facilitate, plan, and coordinate an integrated delivery of care across th...
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 ...
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...
***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...
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......
***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...
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 accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operati...
JOB DESCRIPTIONJob SummaryWorking closely with Molina enterprise Clinical Operations and Health Plan healthcare services leaders, and Medical Economics and Finance teams, drive, plan and manage a comprehensive program foc...
JOB DESCRIPTIONJob SummaryResponsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and sim...
***Remote and must live in Texas***Job DescriptionJob SummaryMolina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance an...
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