***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 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...
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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...
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......
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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 Massachusetts***Job DescriptionJob SummaryProvides leadership and direction to MMS Operational Units management staff (e.g., Claims Processing, Provider Services, Provider Enrollment, Finance, M...
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 SummaryResponsible for achieving established goals improving Molinas enrollment growth objectives, with primary responsibility for Medicaid. Works collaboratively with key departments across the enterpr...
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...
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 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 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 SummaryResponsible for achieving established goals improving Molinas enrollment growth objectives encompassing Medicaid programs. Works collaboratively with key departments across the enterprise to impr...
***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 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 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'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 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 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 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 (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 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 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 DESCRIPTIONOpportunity for TX licensed LVN or Social Worker residing in Harlingen, TX area to join our LTSS Team as a Case Manager working with our Medicaid members. Part of......
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 Advisor, Essential Plan is a field-based role that directly impacts membership growth and retention through sales activities and Business to Business opportunities that support the Essential ...
***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 SummaryResponsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks.KNOWLEDGE/SKI...
Charleston, South Carolina
1 day
JOB DESCRIPTIONJob SummaryResponsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated ...
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 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 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...
Greenville, South Carolina
1 day
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 SummaryResponsible for the development of communications and marketing activities aimed at brand and message management. Develops, implements, and manages communications programs.KNOWLEDGE/SKILLS/ABILIT...
JOB DESCRIPTIONOpportunity for experienced Utilization Review RN in the state of Texas. You will be hired to join the behavioral health inpatient review team doing initial and concurrent reviews, but......
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 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 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 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 Summary Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs specific to the Provider Network; ensures...
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 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......
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...
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 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 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 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 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 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 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 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 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 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 Healthca...
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 Advisor, Essential Plan is a field-based role that directly impacts membership growth and retention through sales activities and Business to Business opportunities that support the Essential ...
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 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...
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...
Candidate must be an RN/BSN, LMFT, LPCC, LCSWJOB DESCRIPTIONJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integr...
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 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 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 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 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 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 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 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...
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 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 Risk & Quality Performance Manager position will support Molinas Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molin...
Molina Healthcareis hiring a Community Connector in or near Snohomish County.This position serves as a community-based member advocate and resource, using knowledge of the community and resources available to engage......
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...
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