Job DescriptionWe are looking for a Social Health Equity Navigator to work and support the Virginia Medicaid health plan as well as members within the community. This position requires you......
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...
We are seeking a CASE MANAGER for our NEW MEXICO Health Plan. Candidates must live in MCKINLEY COUNTY in the state of New Mexico for consideration.Case Managers will work in......
JOB DESCRIPTION******This role is remote and employee must reside in Florida*****Job SummaryClaims Adjuster/Adjudicator is responsible for administering claims payments, maintaining claim records, and providing counsel to...
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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 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...
***Candidates For This Position Must Reside In/Near the Erie County Area***Are you passionate about serving others? Do you have established relationships within the community?Come join our growingCommunity Engagementteam ...
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***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...
JOB DESCRIPTION*****This position is remote and employee must reside in Florida*****Job SummaryAnalyzes complex business problems and claims issues using data from internal and external sources to provide insight to decis...
JOB DESCRIPTIONJob SummaryThe SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip, member benefits...
POPULATION / PUBLIC HEALTH REGISTERED 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......
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...
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 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 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 DESCRIPTIONIdeal Candidate must reside in either of following counties in Michigan.Emmet, Charlevoix, Antrim, Leelanau, Benzie, Grand Traverse, Kalkaska, Manistee, Wexford, MissaukeeJob SummaryMolina Healthcare Servic...
Candidates must be able to work in PST hours 8-5pm M-F.JOB DESCRIPTIONJob SummaryMolina's HEDIS/Quality Improvement Medical Records Collector will work collaboratively in outreaching to providers in order to pursue medica...
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 LPNwho lives in VIRGINIA and must be licensed for the state of VIRGINIA. We are looking for candidates who live in within......
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 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, ...
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 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 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 DESCRIPTIONWe are looking Case Manager who must reside in MI and will work in remotesetting supporting Medicaid Michigan Population. We are looking for candidates that have experience working with......
JOB DESCRIPTIONJob SummaryProvides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values....
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 DESCRIPTIONCase Manager needed in a service delivery area north of Beaumont, TX. Applicants must reside in this area and hold a TX RN license in good standing to be......
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...
JOB DESCRIPTIONJob SummaryResponsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with DMHC and DHCS requirements including ...
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 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 DESCRIPTIONJob SummaryThe Medical Assistant Care Connections will communicate with members after appointments and services to ensure that they are receiving quality care. They will function as a liaison to......
KNOWLEDGE/SKILLS/ABILITIES Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Dise...
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 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 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 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 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 DESCRIPTIONWe are looking for a supervisor that must reside within the state of South Carolina. The Supervisor will manage a team of Case Managers that will support the South......
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 SummaryResponsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and sim...
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 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 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 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 SummaryMust have Claims Medical ExpAnalyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and...
JOB DESCRIPTIONJob SummaryUnder direct supervision of the Manager, SIU, the Team Lead is responsible to lead a small team of investigators and provide oversight on daily investigative activities as 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...
Molina Healthcare of Florida is hiring for several Sr. Claims Examiners.These roles remote, however candidates must reside in Florida.Ideal candidates will have experience with claims adjudication, claims edits, payout ev...
Molina Healthcare of Floridais hiring for several Claims Examiners.These positions are remote; however, all candidates must reside in the state of Florida.Those with Health Insurance call center experience are encouraged....
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......
JOB DESCRIPTIONOpportunity for a Bachelors/Masters trained Social Worker in Illinois to join one of our Medicare Teams as a Case Manager in in the Illinois part of metro St. Louis,......
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 US licensed RN to do prior authorization reviews with Molina Healthcare. Applicants call across the contiguous US states are eligible to apply but must be willing/able......
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 analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and sim...
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...
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 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......
**** We are looking for candidate who can work in PST hours. ******JOB DESCRIPTION Job Summary Designs and implements processes and solutions associated with a wide variety of data sets......
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 Member Navigator primary function is to be the member's liaison. Primarily telephonic, this role is responsible for ensuring that the members member has assistance they may need......
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 DESCRIPTIONCase 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 be required to......
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 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 SummaryThe Manager, Business Development, Facilitated Enrollments, is responsible for for overseeing daily operations and driving individual and team performance. The Manager will lead a team of Facilit...
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 Description Job SummaryThe Sr Video Producer manages and elevates the brand of all entities under the Molina Healthcare and the MolinaCares Accord name, providing the video production for all......
JOB DESCRIPTIONOpportunity for a RN licensed in Illinois to join one of our Medicare Teams as a Case Manager in the Illinois part of metro St. Louis, MO. Part of......
JOB DESCRIPTIONOpportunity for a Registered Nurse to provide Case Management services to our Medicaid members in the Beaumont/Orange, TX, Service Delivery Area. Applicants must hold an active RN license in......
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 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...
***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...
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 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 customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values....
JOB DESCRIPTIONJob SummaryProvides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values....
JOB DESCRIPTIONJob SummaryThe Analyst, Clinical Policy reviews and evaluating existing clinical policies, proposes suggested improvements to existing clinical policies, and researches new policies. Creates reports and ana...
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......
***Remote and must live in Michigan***Job DescriptionJob SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignmen...
We are seekingaRN (Registered Nurse) Case Manager for Washoe County, NEVADA. Qualified candidate must currently live in Washoe County. Must be licensed as a RN for the state of NV.......
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 SummaryClinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance standards.KNOWLEDGE/SKILLS/ABILITIES The Clinical Appeals Nurse (RN) p...
JOB DESCRIPTIONJob SummaryManages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design pro...
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...
INPATIENT REVIEW : REGISTERED NURSEWORK SCHEDULE: 5 days / daytime work schedule M - F 8:30AM to 5:30PM with some weekends and holidays. Candidates who do not live in Pacific......
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 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...
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 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 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 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 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...
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