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 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 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 SummaryResponsible for managing and overseeing KPI and SLA reporting for the department, ensuring accuracy, timeliness, and quality in delivery and synergy across reporting platforms. Briefs executives ...
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......
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......
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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...
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 Description Job 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 a...
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 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 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 SummaryThe Director of Data Governance will build and execute the enterprise data governance strategy and roadmap in alignment with the company's vision. This role is within the company's......
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 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 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 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 SummaryThe Sr. Analyst, Advanced Provider Data Management is responsible for analyzing and understanding business processes, identifying areas for improvement, and developing solutions to optimize perfo...
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......
Job DescriptionJob SummaryAs the Senior Consultant, Protection Services Operations Center (PSOC), you will be a member of Molina Healthcares Protection Services Operations Center, reporting to the Director. This role will...
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 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 the alignment of strategic goals and organization objectives to the business project portfolio. Provides direct input into the governance cycle that supports the achievement of key......
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 estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Knowledge...
JOB DESCRIPTIONJob SummaryThe Regional Manager Value Based Programs plays a critical role in the implementation of value-based programs and contracts by supporting both the local markets and national value based......
Job DescriptionJob Summary Responsible for leading the Medical Economics team to develop SAI tracking tools in conjunction with SAI leads to support of Health Plans data management needs. Collaborates with......
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 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 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 other end users for op...
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 planning, developing and directing the implementation of techniques to ensure the maintenance of performance and quality levels in the Business' products and processes. Reviews o...
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 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 AVP, Compliance is responsible for oversight and management of health plan or product compliance activities and serves as a resource on compliance issues. Provides leadership and expertise......
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 SummarySupports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor activities. Provides daily operational support to the vendors. Monitors inventory levels,...
Job Description Preferred Bilingual: Spanish, Vietnamese, Cantonese, Mandarin, Tagalog and French Required License: Active and unrestricted Life and Health Insurance LicenseJob SummaryTelesales role. Responsible for takin...
Job DescriptionJob SummaryMolina's HEDIS/Quality Improvement Sr. Medical Records Collector is a team member with several years experience in working collaboratively with outreaching to providers in order to pursue medical...
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 DescriptionJob SummaryThe Lead Analyst, Advanced Provider Data Management is responsible for analyzing and understanding business processes, identifying areas for improvement, and developing solutions to optimize perf...
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 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 SummaryManages people who are responsible for internal business projects and programs involving contact center department or cross-functional teams of subject matter experts, delivering products through...
Job DescriptionJob SummaryThe Sr. Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and develops reporting solutions to assist HEDIS audit, rate tracking, an...
Job DescriptionJob SummaryThe Sr Analyst, Risk Adjustment - Predicitve Analytics role supports Molina's Risk Adjustment Predictive Analytics team. Designs and develops Suspect, Targeting, and Tracking System to suport Mol...
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 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 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 SummaryResponsible for conducting analyses of insured medical populations with the goal of identifying opportunities to improve financial performance. Extract, analyze, and synthesize data from various ...
JOB DESCRIPTIONJob SummaryWe are looking for an adaptable actuary to assist in pricing Molina Marketplace ACA Individual Products. The right candidate should be comfortable working on a product with changing......
JOB DESCRIPTIONJob SummaryUse of general accounting principles and rules to create financial reports and analysis. Duties include all aspects of the Accounting function, such as, control of accounts and records,......
Knowledge/Skills/AbilitiesActs as liaison between Special Investigations Unit (SIU) operations and contracted vendor(s) to assure a smooth workflow exists, quality assurance measures are designed and monitored, appropriat...
Job DescriptionJob SummaryThis role will be responsible for developing and implementing data strategies that enhance data quality, governance, and analytics capabilities across the organization. This role requires a deep ...
Job DescriptionJob SummaryMolinas Quality Management function implements, oversees, and maintains new and existing healthcare quality monitoring activities and programs; ensures quality monitoring audits and investigation...
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 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 SummaryMolina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality improvement initiatives and education programs to support improved Star Ratings....
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 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 SummaryThe Business Control Process Design and Implementation Senior, under the direction of Mgr, IT Controls and ERM, is responsible for developing a risk based process design approach for......
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 SummaryUtilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, b...
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 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 i...
Job DescriptionJob SummaryAssist business teams with developing requirements for major projects of considerable complexity, prepares system design specifications, conducts research to resolve customer-initiated issues rel...
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 SummaryServes as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are appropriately applied. Manages and leads major claims projects of con...
JOB DESCRIPTIONJob SummaryPlans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs, and......
Job DescriptionJob SummaryWe are seeking an experienced and strategic Director of Financial Planning & Analysis to join our team. In this critical role, you will lead the planning, budgeting, and......
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 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 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 ...
This position is 100% remote. Working hours are M-F 7:30am-4:30pm must work PST hoursJob DescriptionJob SummaryResponsible for conducting various audits including, but not limited to; vendor, focal, audit the auditor.......
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 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 Summary Architects company specific systems and technology expertise across multiple infrastructure and development disciplines. Applies and promotes key principles (e.g. stability, scalability, perfor...
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 SummaryAssist business teams with developing requirements for major projects of considerable complexity, prepares system design specifications, conducts research to resolve customer initiated issues rel...
JOB DESCRIPTIONJob SummaryResponsible for Enrollment related 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 Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for membe...
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 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 SummaryPerform data and error analysis to improve models, and clean and validate data for uniformity and accuracy. Execute data science and statistical analytical experiments methodically to help solve....
Job DescriptionJob SummaryActive collaborator providing bi-lateral support around the redlining; negotiating; formal execution of contractual obligations between outside party and Molina Healthcare. Serves as key role pla...
Job DescriptionJob Summary Focuses on process improvement, organizational change management, project management and other processes relative to the business. Project management includes estimating, scheduling, costing, pl...
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 builds company specific enterprise application systems and technology expertise across multiple disciplines.Applies and promotes key principles (e.g., stability, scalability, performa...
Job DescriptionJob SummaryProvides consultative support and medical cost-based analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrentl...
JOB DESCRIPTIONJob SummaryThis role will execute the enterprise data governance strategy and roadmap in alignment with the company's vision. This role is within the company's Enterprise Information Management (EIM) organi...
JOB DESCRIPTIONFor this position we are seeking a (RN) Registered Nurse who must have a current active unrestricted RN license in the state of OH (Compact Licensure)Case Manager RN will......
Job DescriptionJob SummaryLead data science and analytics initiatives to drive strategic decision-making and operational efficiency. Oversee the development and implementation of data models, ensuring data integrity and a...
Job DescriptionJob SummaryMolinas Quality Management function implements, oversees, and maintains new and existing healthcare quality monitoring activities and programs; ensures quality monitoring audits and investigation...
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