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...
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......
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......
***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...
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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...
***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 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...
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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 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...
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 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 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 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*****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 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 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 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 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 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 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 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......
*****Candidate must be able to work in PST Time zones.*****Job Overview: The IT Sr. Systems Analyst is responsible for the analysis, design, and implementation of IT Healthcare Compliance & regulatory......
JOB DESCRIPTIONWe are seeking licensed social worker, who must live in the Dayton OH area, and must be licensed for the state of OHIO.The Case Manager will support MMP Waiver......
Job DescriptionJob SummaryThe Mgr, Risk and Quality Systems supports Molinas Risk & Quality Solutions (RQS) team by overseeing daily operations, managing team performance, and driving achievement of goals. This role.....
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 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...
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 (Purpose of the Job & high-level summary):The Molina Healthcare Internship Program shares an objective to create a steppingstone for students who aim to be professionals and future......
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 DESCRIPTIONOpportunity for experienced, non-RN Case Manager to join our LTSS Team working with our Medicaid members in the Galveston, TX service delivery area. Part of the responsibilities of the......
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 SummaryMolina Segment leaders are responsible for the development and administration of Segment specific departments, programs and services, in alignment with Molina Healthcare's overall mission, core v...
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 accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operati...
JOB DESCRIPTIONJOB SUMMARY (Purpose of the Job & high-level summary):The Molina Healthcare Internship Program shares an objective to create a steppingstone for students who aim to be professionals and future......
JOB DESCRIPTIONJob SummaryThe Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and accurate reports. As the senior level team member, this role leads......
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 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 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 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 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 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...
***Remote and muct live in the New York metropolitian area***Job DescriptionJob SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and...
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 TX licensed LVN or an experienced Case Manager to join Molina as a Case Manager working with our Medicaid members in the service delivery area of Fort......
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 SummaryThis position will be supporting the Kentucky and New Mexico Health plansResponsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Mai...
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...
Greenville, South Carolina
6 days
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 SummaryMolinas Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs specific to the Provider Network; ensures m...
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 DESCRIPTIONFor this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of MI.Case Manager RN will......
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 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...
Molina Healthcareis hiring in/near the Everett area. We are in search of a Community Health Worker / Justice System Liaison. This position serves as a community-based member advocate and......
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...
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......
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...
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 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 SummaryThe Sr. ER Consultant is generally responsible for the following: Mitigating risk for the organization and creating capacity for people leaders in counseling and guiding them through complex......
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 SummaryManages the activities of the Data Analytics and Reporting team. Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and......
Job SummaryGeneral accounting tasks for tracking, processing, and payment of invoices for services or goods purchased from vendors. Responsibilities include ensures all disbursements are made under good financial controls...
JOB DESCRIPTIONJob SummaryTMG by Molina Healthcare is seeking a remote IRIS Consultant Supervisor for Milwaukee County.IRIS Consultant Supervisors provide leadership management and supervision to a team of IRIS Consultant...
***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 SummaryCritical partner in the strategic planning process by providing input to the scope definition of strategic initiatives leveraging capabilities, creating capability Heatmaps to provide visibility ...
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 Healthcare is Hiring for a Manager of Growth & Community Engagement in Rochester, Buffalo, or Syracuse**To be considered for this role, applicants must live in or newar one of......
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...
***Remote and must live in Massachusetts***JOB DESCRIPTIONJob SummaryAnalyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interp...
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: 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...
***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 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 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 cont...
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