JOB DESCRIPTION*****Candidates based in Michigan are highly preferred. ******Job SummaryResponsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical in...
**Must live in the state of California.If licensed, must be licensed for the state of California.JOB DESCRIPTIONJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members ...
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 Sr Risk & Quality Performance Manager is a tactical execution role that will lead specific projects to support Molinas Risk & Quality Solutions (RQS) team and program......
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Job DescriptionJob SummaryThe Lead Risk and Quality Performance Manager supports Molinas Risk & Quality Solutions (RQS) team by overseeing large programs and multiple projects supporting Molinas Risk Adjustment and Qu...
Job DescriptionJob SummaryThe Specialist, Functional Screen - MCW is responsible for completing the Long-Term Care Functional Screen (LTCFS) for MCW Family Care and Family Care Partnership members, as required, 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......
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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 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: Program Manager: HCS, Clinical Program Design, REGISTERED NURSEJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordi...
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****** 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......
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 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 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 SummaryPerforms 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 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 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...
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 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 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 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 DESCRIPTIONNon-RN Case Manager position available in Chicago, IL service delivery area. Applicants should reside in the community and have experience working as a case manager in nursing facilities. Part......
Job DescriptionFor this position we are seeking Licensed Social worker who must live and have a current active unrestricted license in the state of MIWe are looking Case Manager who......
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 in Illinois to join our case management team working with our Medicaid members with a Behavioral Health diagnosis. This is open to qualified candidates across the state; applicants......
Job DescriptionFor this position we are seeking Licensed Social worker who must live and have a current active unrestricted license in the state of OH.We are looking for a Licensed......
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 Summary As the Manager, Workforce Risk, you will be a member of Molina Healthcares Protection Services Operations Center, reporting to the AVP. This role will be responsible for......
Knowledge/Skills/Abilities Responsible for program development, implementation, and management of process improvement initiatives. Coordinates, directs, and manages the activities of the department and the process improve...
JOB DESCRIPTIONJob SummaryManages a team of professional Configuration Analysts. Responsible for operational activities for the assigned team, including accurate and timely implementation and maintenance of critical infor...
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 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 SummaryLeads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of MHI's business process improvement me...
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 SummaryUnder supervision, applies software engineering methods and techniques to the design, development, integration, qualification and/or support of Microsoft Reporting Services, SQL stored procedures...
JOB DESCRIPTIONJob SummaryA successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ability to work independently, self-navigate organizatio...
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 SummaryManages a team of professional Configuration Analysts. Responsible for operational activities for the assigned team, including accurate and timely implementation and maintenance of critical infor...
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 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......
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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...
***Candidates For This Position Must Reside in/near the San Gabriel Valley or Pomona*** **Bilingual Mandarin/ or other Asian Languages Needed**Are you passionate about serving and helping your community? Do you......
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 Nurse Practitioner Psychiatric-Mental Health (PMHNP) will work primarily in non-clinical settings and provide medical care to all levels of patients. Some programs may focus on specific popul...
Job DescriptionJob SummaryProvides direct spiritual care and support for members of all lines of business, patients, families and staff from all religious/faith backgrounds and belief systems for Molina Health Plan......
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......
Molina Healthcare of Kentuckyis hiring for Community Connectors for our Tobacco Cessation program.This role is remote; however candidates should live in or near the Lexington-Fayette metropolitan area.These roles will be....
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 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......
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 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 Mississippi***Job DescriptionJob SummaryMolina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performa...
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 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...
***Remote and must live in Illinois***JOB DESCRIPTIONJob SummaryDevelops and implements initiatives and projects supporting provider engagement. Responsible for continuous quality improvements. Supports robust provider en...
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 SummaryDevelops, administers and implements all training programs inaccordance with the Business' initiatives and strategies. Conducts special courses designed for training selected groupsof employees. ...
Job DescriptionFor this position we are seeking Licensed Social worker who must live and have a current active unrestricted license in the state of OH.We are looking for a Licensed......
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 Licensed Social worker who must live and have a current active unrestricted license in the state of OH.We are looking for a Licensed......
Job DescriptionJob SummaryManage new broker applications, enrollment forms, educating on plan benefits in all markets and making sure CMS requirements are being met in these processes. Knowledge/Skills/Abilities Handles n...
Job DescriptionOpportunity in Illinois to join our case management team working with our Medicaid members with a Behavioral Health diagnosis. This is open to qualified candidates across the state; applicants......
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 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 SummaryManages a team responsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risk...
JOB DESCRIPTIONJob SummaryResponsible for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with the standards and re...
Molina Healthcareis hiring for aPharmacy Technicianwho is State Licensed/Certified and/or PTCB certified.This role is 100% remote, and the hours will be Mon-Fri 10am to 630pm Pacific Standard Time.This role will......
Molina Healthcareis hiring for Pharmacy Technicians who are State Licensed/Certified and/or PTCB certified.This role is 100% remote, and the hours will be Mon-Fri 10am to 630pm Eastern Standard Time.This role......
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 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 SummaryPerforms 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 DESCRIPTION***** Candidate must be able to work during EST hours*****Job SummaryPerforms research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost......
JOB DESCRIPTIONJob SummaryPerforms 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 DESCRIPTIONJob SummaryResponsible for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with the standards and re...
Job DescriptionJob SummaryResponsible for all Configuration Information Management operational activities for the assigned team, including accurate and timely implementation and maintenance of critical information on clai...
JOB DESCRIPTIONCase Manager RN will work in remote and field setting supporting our Medicaid Population (Including Maternity and Pediatric Population. Complete assessments, create care plans, and provides educations to ou...
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......
Molina Healthcare of Kentuckyis hiring for Community Connectors for our Tobacco Cessation program.This role is remote; however candidates should live in or near the following counties- Bullitt, Hardin, or Jefferson.These....
JOB DESCRIPTIONJob SummaryResponsible for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with the standards and re...
Job DescriptionJob SummaryMolina's Quality Improvement Abstraction team functions to conduct data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The...
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...
***Remote and must live in South Carolina***Job DescriptionJob SummaryMolina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial perfo...
JOB DESCRIPTIONJob SummaryThe Manager, Delegation Oversight position is responsible for the management of staff and oversight of delegated activities, ensuring compliance with State, Federal, NCQA, and Molina delegation s...
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 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 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 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 DescriptionLicensed Social Worker Case Manager residing in the state of UT, will work in remote setting supporting our Medicaid SMI (Severe Mental Illness) & Substance Abuse Population in the......
Job DescriptionOpportunity open for a KY licensed Social Worker (LCSW, LPC, LPCC, LMFT) to join our health plan in the state of Kentucky. Applicants should have experience working with persons......
JOB DESCRIPTIONOpportunity for TX licensed LVN or an experienced non-RN case manager residing in the service delivery area of Donna and Mercedes, TX, to join our LTSS Team as a......
Job DescriptionOpportunity in Texas to join our case management team working with our Medicaid members with a Behavioral Health diagnosis. This is open to qualified candidates across the state; applicants......
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......
Molina Healthcareis hiring for Pharmacy Technicians who are State Licensed/Certified and/or PTCB certified.This role is 100% remote, and the hours will be Mon-Fri 9am to 530pm or 11am to 730pm......
JOB DESCRIPTIONOpportunity for a TX licensed RN with experience working in womens health; specifically, OB, L&D, or postpartum, to join our Texas Health Plan as a Case Manager. Your caseload......
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 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 DESCRIPTIONOpportunity for TX RN to join Molina as a Case Manager in Bexar County. Applicants should reside in the county and have experience working as a case manager in......
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