***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 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 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 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...
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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 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 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...
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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. Assist with HTML, CSS and Javascript coding. Reviewing medical ...
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 cont...
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 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...
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 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 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 SummaryResponsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare/MMP product in support of strategic and corporate business objectives. Supp...
*****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......
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 have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner......
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 SummaryThe role is responsible for establishing premium rates and conducting financial analysis and reporting. A key responsibility of this role is supporting the Molina Marketplace ACA individual prici...
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 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 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.....
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 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...
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 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 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 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 SummaryWorking closely with Molina enterprise Clinical Operations and Health Plan healthcare services leaders, and Medical Economics and Finance teams, drive, plan and manage a comprehensive program foc...
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......
Molina Healthcare is hiring for a remote Pharmacy Operations SpecialistThis role can be worked remotely anywhere within the US.This role will be the primary contact for affiliated health plans, Pharmacy......
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 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 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 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......
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 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...
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 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...
Job DescriptionJob SummaryMolina's Quality Improvement Sr. Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction t...
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 SummaryProvider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence...
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 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 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......
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 SummaryThis role on the Customer Experience team will be responsible for technically based projects like liaising with IT to upgrade Salesforce or create visions for technical solutions that......
Job DescriptionJob SummaryThe Risk & Quality Performance Manager position will support Molinas Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molin...
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 SummaryThe AVP, Clinical Validation (PI) role within Payment Integrity utilizes clinical background andrelevant experience to lead the Clinical Operations team, consisting of clinical staff and certifie...
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 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 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 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 Lead, Risk Adjustment - Predictive Analytics role supports Molina's Risk Adjustment Predictive Analytics team. Designs and develops Suspect, Targeting, and Tracking System to support Molinas ...
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 Molina 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, ...
Molina Healthcareis hiring for a Pharmacy Technician, Clinical Operations. This role is 100% remote.Ideal candidates will have experience in PBM and/or HealthPlan, along with above average skills in Excel and......
JOB DESCRIPTIONJob SummaryJob SummaryResponsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data am...
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 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...
Job DescriptionJob SummaryAssists attorneys in research activities and in the preparation of documents. Deals with highly confidential matters and may act as a source of organizational policies and procedures. Works......
JOB DESCRIPTIONJob SummaryAnalyzes complex business problems and issues within Payment Integrity Pre-Pay using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trend...
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 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 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 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 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...
JOB DESCRIPTIONJob Summary:The Claims Research Coordinator is responsible for reviewing claims to understand the root cause of issues and collaborating with various teams to identify and implement fixes. This role......
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 DESCRIPTIONOpportunity to join our Marketplace Team as a Program Manager. Applicants should have a clinical background, at least 5 years of experience within a Managed Care Organization with at......
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 SummaryThe Vice President, Managed Care Enterprise Integration is responsible for managing the successful delivery and launch of a portfolio of growth projects for the company - including new market......
Job DescriptionJob SummaryMolina's Quality Improvement Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The lead abstrac...
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