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...
Molina Healthcare of Nevadais seeking a dynamicBilingual Community Engagement & Growth Sr Specialistin/near theClark Countyarea.Bilingual in any language, with Asian languages being a plus!This role will help drive ch...
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 provider networks and o...
Job Description****** This position will require a start time at 7:30am PST or later (must).*******Job Summary Responsible for conducting various audits including, but not limited to; vendor, focal, audit the......
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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...
Charlottesville, Virginia
1 day
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...
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Knowledge/Skills/AbilitiesPerforms research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healt...
Job SummaryProvides support to the clinic operations by adding assistance when applicable. Helps ensure satisfaction is achieved for patients. Knowledge/Skills/Abilities Scheduling: Managing and coordinating the schedules...
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...
This position is Remote/Hybrid. Candidates must reside in Phoenix, AZ.Job DescriptionJob SummaryResponsible for coordinating and overseeing contractually required workforce development activities. This includes developing...
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......
***Remote and must live in Arizona***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 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......
Job DescriptionJob SummaryMolina MTM Pharmacy Services staff work to ensure that Molina members have access to Medicare Star medications and those meds are used in a cost-effective, safe manner. These......
JOB DESCRIPTIONJOB SUMMARYThe Molina Healthcare Internship Program shares an objective to create a steppingstone for students who aim to be professionals and future leaders in the healthcare business profession. Interns.....
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...
***Remote and must live in the Central time zone***JOB DESCRIPTIONJOB SUMMARY (Purpose of the Job & high-level summary):The Molina Healthcare Internship Program shares an objective to create a steppingstone for......
JOB DESCRIPTIONJob SummaryThe Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for......
Job Description Job Summary Interfaces with the customer in developing requirements for major complex claims testing projects within Medicare, Medicaid and Marketplace; prepares system test design specifications; conduct...
***Remote and must live in New York***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 role, we are seeking a RN Complex Case Manager. Must reside and be licensed for the state of NEBRASKA.JOB DESCRIPTIONJob SummaryMolina Healthcare Services (HCS) works with members, providers......
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 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...
***Remote and must live in Massachusetts***Job DescriptionJob SummaryProvides leadership and direction to MMS Operational Units management staff (e.g., Claims Processing, Provider Services, Provider Enrollment, Finance, M...
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 overseeing data science projects, managing and mentoring a team, and aligning data initiatives with business goals. Lead the development and implementation of data models, collabo...
Job DescriptionJob Summary*****This position will be focused on the Medicare STARS program. Please highlight your experience on your application. ******Designs and implements processes and solutions associated with a wide...
JOB DESCRIPTIONJob SummaryThe Program Director, PMO (Business Integration) will support program activity related to integration of a single merger and acquisition or implementations to further Molinas growth, business su...
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 we are seeking a Case Manager who lives in VIRGINIA and must be licensed for the state of VIRGINIA.Case Manager will work in remote and field......
JOB DESCRIPTIONJob SummaryProvides application technical support and design on clinical information systems. Applies system knowledge to create workflows, change management processes, and ensure enhancements and defects a...
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 SummaryThis position is part of the health plan finance team and supports the financial management of the WI health plan. The individual in this role will assist with......
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 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 DESCRIPTIONJob SummaryThis role is on the Corporate Financial Planning and Analysis team primarily supporting G&A submissions. The successful candidate in this position will assist in the management of G&A......
Job DescriptionJob SummaryBusiness Strategy Leader managing relationships and providing process expertise with Molina health plan leadership, corporate leadership, business subject matter experts (SMEs), business and IT o...
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...
***Remote and must lives in Massachusetts***JOB DESCRIPTIONJob SummaryProvider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims an...
Greenville, South Carolina
today
JOB DESCRIPTIONCase Manager RN will support our Medicare Population in the state of South Carolina. Case Manager will be required to communicate telephonically with our members completing assessments, care plans,......
JOB DESCRIPTIONJob SummaryMolina Pharmacy Services/Management staff work to ensure that Molina members, providers, and pharmacies have access to all medically necessary prescription drugs and those drugs are used in a......
JOB DESCRIPTIONJob SummaryEstablish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraud...
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 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 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 Summary Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and deploying reports to provider networks and ...
JOB DESCRIPTIONJob SummaryThe role is responsible for supporting the establishment of premium rates and conducting financial analysis and reporting. A key responsibility of this role is supporting the Molina Marketplace.....
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......
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...
This position is 100% remote. Working hours are M-F 7am-4pm PST.Job DescriptionJob SummaryResponsible for conducting various audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentati...
** NEVADA residents preferred. RN licensure for NEVADA required. Pacific Time Zone hoursKNOWLEDGE/SKILLS/ABILITIES Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM),...
Molina Healthcare of Ohio is hiring for a Community Connector in the Franklin County area.High preference for those who have the Community Health Worker (CHW) certification. Bilingual, English/Spanish is also......
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 SummaryResponsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks.KNOWLEDGE/SKI...
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 lives in VIRGINIA and must be licensed for the state of VIRGINIA.Case Manager will work in remote and......
JOB DESCRIPTIONJob SummaryThe Molina Healthcare Internship Program shares an objective to create a steppingstone for students and alumni who aim to be professionals and future leaders in the healthcare business......
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 SummaryManages a process that blends standard actuarial modeling, medical economics, and financial reporting and analytics. Analyzes data for cost savings opportunities and performance improvement initi...
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 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......
This position requires an actively licensed Registered NurseJOB DESCRIPTIONJob SummaryThe mission of Clinical Operations is to drive value through an integrated Clinical Center of Excellence and to deliver value through.....
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 SummaryDigital Channel Managers are Subject Matter Experts (SMEs) in their channels. They are responsible for defining the long term vision for their channels, providing ongoing business production supp...
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...
Molina Healthcareis hiring for aHealth Plan Operations, Payment Integrity Program Manager.This role is fully remote.This Program Manager role will be responsible for oversight, production, and resolution of Health Plan Pa...
***Remote and must live in the Las Vegas area***Job DescriptionJob SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, i...
JOB DESCRIPTIONLicensed Social Worker Case Manager will work in remote and field setting supporting our Medicaid SMI (Severe Mental Illness) Population in the state of South Carolina. Case Manager will......
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 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 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 the...
JOB SUMMARY:The Molina Healthcare Internship Program shares an objective to create asteppingstone for students who aim to be professionals and future leaders in the healthcare business profession. Internsare assigned spec...
**California residents preferred; Pacific Time Zone hours.JOB DESCRIPTIONJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordin...
JOB DESCRIPTIONOpportunity open to TX RN in the West Forth Worth service delivery area to work as a Field Case Manager with our Medicaid members there. The schedule is Monday......
Molina Healthcare of Nebraska is hiring for a Health Plan Communications Specialist.This role can be worked remotely.Highly Qualified Candidates Will Have The Following Experience- Health Insurance (preferably Managed Car...
***Remote and must live in California***Job DescriptionJob SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignm...
**California residents preferred. California RN licensure required. Monday thru Friday, 10:00AM to 7:00PM with some weekends and holidays. Pacific Time Zone business hours required.JOB DESCRIPTIONJob SummaryMolina Healthc...
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 Summary Responsible for collecting, storing, processing, and analyzing large sets of data. The primary focus will be on choosing optimal solutions to use for these purposes, then maintaining,......
Job DescriptionLicensed Social Worker Case Manager will work in remote and field setting supporting our Medicaid SMI (Severe Mental Illness) Population in the state of South Carolina. Case Manager will......
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 SummaryCollects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and deploying reports to provider networks and o...
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 SummaryFocuses on process improvement, organizational change management, project management and other processes relative to the business. Project management includes estimating, scheduling, costing, pla...
Molina Healthcare is hiring for a Care Coordinator. This role is remote with a preference for location being in/near southeastern Wisconsin.The (non-clinical) Care Coordinator works with members, providers and multidiscip...
Job SummaryDesigns and implements processes and solutions associated with a wide variety of data sets using MS Excel, SQL and DataBricks for data/text mining, analysis, modeling, and predicting to enable......
Molina Healthcare of Kentuckyis hiring for a Community Connector.Candidates for these roles must reside in or near Bullitt, Hardin, or Jefferson County.Molina Healthcare Services (HCS) works with members, providers and......
Job DescriptionJob SummaryFocuses on large scale process improvement, organizational change management, project management and other processes relative to the business and enterprise. Project/delivery management includes ...
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...
***Home office, with field travel. Must live in Clark County , NEVADA to meet travel requirements.Job DescriptionJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members...
Washington, District of Columbia
today
Job DescriptionJob SummaryThe Program Manager, Provider Engagement Programs is part of our innovative WA Quality & Risk Adjustment department to assist our diverse team of data leaders, quality & risk......
JOB DESCRIPTIONOpportunity for TX licensed RN to join Molina as a Case Manager working with our Medicaid members in the service delivery area of Houston, TX. Part of the responsibilities......
JOB DESCRIPTIONCase Manager RN will work in remote and field setting supporting our Medicaid Population. This team supports Pediatric, Foster Care, Maternity and Adult Medicaid population. Complete assessments, create car...
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...
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