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 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 DESCRIPTIONSocial Worker Case Manager will work in remote and field setting supporting our Medicaid SMI (Severe Mental Illness) Population in the state of South Carolina. Case Manager will be......
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...
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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, ...
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 MICase Manager RN will......
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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 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...
***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 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 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 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...
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 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 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...
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......
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......
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 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 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 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 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 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 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 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 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 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 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 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 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......
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 Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care...
Charleston, South Carolina
5 days
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...
***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 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...
Washington, District of Columbia
7 days
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 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 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......
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......
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 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 DESCRIPTIONFor this position we are seeking a (RN) Registered Nurse who must have a current active unrestricted RN license in the state of TX (Compact Licensure)Case Manager RN will......
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 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 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 provider networks and 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 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...
Work Schedule: Monday thru Friday 11:30AM to 8:30PM PACIFIC HOURSCandidates who do not live in the Pacific Time Zone must work Pacific Hours.JOB DESCRIPTIONJob SummaryMolina Healthcare Services (HCS) works 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 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 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......
Molina Healthcare is hiring for a Sr. Corporate Paralegal. This position is remote and can be worked from a variety of locations within the US. This role will be working......
JOB DESCRIPTIONOpportunity for an experienced, Illinois Licensed Social Worker to join our LTSS Team working with our Medicaid members currently in nursing facilities in the Illinois Counties of Sangamon, Madison,......
***Remote and must live in California***Job DescriptionJob SummaryProvider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and pr...
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 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 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 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) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, i...
Washington, District of Columbia
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 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 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......
null Pay Range: $26.41 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level....
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 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 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 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 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...
**California residents preferred. In office requirement Long Beach, CA / HYBRID.JOB DESCRIPTIONJob SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facili...
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 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 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, but......
JOB DESCRIPTIONJob SummaryMolina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthca...
JOB DESCRIPTIONOpportunity for Texas licensed RN to join Molina as a Case Manager working with our Medicaid members in the El Paso, TX service delivery area. Part of the responsibilities......
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 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 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 SummaryThe 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, and Id...
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 SummaryProvide screening of candidates toward identification of qualified, eligible prospects related to both long-term care needs and Medicaid coverage for enrollment. Assist our current members with r...
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......
** NEVADA residents preferred. RN licensure for NEVADA required. Pacific Time Zone hoursKNOWLEDGE/SKILLS/ABILITIES Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM),...
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