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Job Description Job Summary Designs, develops, and communicates technology models and foundations used to run applications, data, and infrastructure in support of one or more business processes. Applies and promotes......

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Sr Rep, Enrollment - Remote

Molina Healthcare

Louisville, Kentucky

5 days

JOB DESCRIPTIONJob SummaryThe Sr Rep, Enrollment handles all processes related to membership eligibility inquiries and ensures membership accuracy within the system. Represents Enrollment Operations as a subject matter ex...

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Behavioral Health Clinician (Utilization Management) KENTUCKY

Molina Healthcare

Lexington, Kentucky

1 day

For this position we are seeking a Registered Nurse or Licensed Social Worker with PSYCH / BH Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. Excellent......

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Care Review Clinician, Inpatient Review (RN): Kentucky

Molina Healthcare

Louisville, Kentucky

1 day

CARE REVIEW CLINICIAN INPATIENT REVIEW REGISTERED NURSE: KENTUCKY REMOTE(2 openings)For this position we are seeking a Registered Nurse with previous Utilization Review / Utilization Management and knowledge of Interqual ...

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Tuesday, October 22, 2024

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Thursday, October 24, 2024

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Pharmacy Technician (National & State License)

Molina Healthcare

Louisville, Kentucky

today

JOB DESCRIPTION***This remote position (anywhere in the US) will work primary M-F with rotating weekends & holidays***Job SummaryMolina Pharmacy Services/Management staff work to ensure that Molina members have access...

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Coordinator, Physician Service

Molina Healthcare

Louisville, Kentucky

1 month

Job SummaryProvides support to the clinic operations by adding assistance when applicable. Helps ensure satisfaction is achieved for patients.Knowledge/Skills/Abilities Responsible for the administrative support to the re...

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Specialist, Quality Interventions/QI Compliance- Remote

Molina Healthcare

Louisville, Kentucky

2 months

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...

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Medical Director, Behavioral Health

Molina Healthcare

Louisville, Kentucky

27 days

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...

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Sr Engineer, Applications - .Net/AI/QNXT - Remote

Molina Healthcare

Bowling Green, Kentucky

1 month

Job DescriptionJob SummaryDesigns, develops, and communicates technology models and foundations used to run applications, data, and infrastructure in support of one or more business processes. Applies and promotes key pri...

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Lead Business Analyst (Encounters)

Molina Healthcare

Louisville, Kentucky

23 days

JOB DESCRIPTIONJob SummarySupporting the OH Plan, the candidate will act as a liaison to our state regulator on Encounters as well as lead various other technical programs under the OH......

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AVP, Performance & Operations Management (HEDIS/Quality) - REMOTE

Molina Healthcare

Louisville, Kentucky

15 days

Job DescriptionJob SummaryResponsible for planning, developing, and directing the implementation of strategies to ensure high levels of performance and quality within the established quality improvement processes and prog...

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Peer Specialist (Hybrid - Jefferson County)

Molina Healthcare

Louisville, Kentucky

7 days

This is a hybrid role. Candidates must reside in Jefferson County.JOB DESCRIPTIONJob SummaryMolina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for ...

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LVN Case Manager: Maternal Health Nurse

Molina Healthcare

Louisville, Kentucky

2 days

We are seeking LICENSED VOCATIONAL NURSES (LVN /LPN) NURSE CASE MANAGER.(2 positions available). Bilingual Spanish preferred but not required.Prior experience with Maternal Health preferred but not required.Must be a LVN....

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Director, Customer Experience (IT Solutions - QNXT & Salesforce) - REMOTE

Molina Healthcare

Louisville, Kentucky

1 day

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......

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Risk & Quality Performance Manager (Remote)

Molina Healthcare

Louisville, Kentucky

1 day

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...

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Manager, Provider Contracts

Molina Healthcare

Louisville, Kentucky

1 month

***Remote and must live in Kentucky***Job DescriptionJob SummaryMolina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance...

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Analyst, Clinical Informatics

Molina Healthcare

Kentucky

28 days

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...

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Care Review Clinician, Inpatient Review (RN)

Molina Healthcare

Louisville, Kentucky

21 days

For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.......

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Care Connections Representative - (REMOTE) must be Bilingual (Chinese, Vietnamese, Korean or Spanish)

Molina Healthcare

Kentucky

21 days

JOB DESCRIPTIONJob SummaryThe Care Connections Representative primary focus is to conduct outbound calls to Molina members and schedule appointments with our Nurse Practitioners. As part of Molina's benefit package, the.....

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Program Manager (NCQA Accreditation - QI Improvement)

Molina Healthcare

Louisville, Kentucky

6 days

JOB DESCRIPTIONJob SummaryResponsible for Quality Improvement projects and programs involving department or cross-functional teams of subject matter experts, delivering results through the design process to completion. Pl...

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Pharmacy Technician

Molina Healthcare

Louisville, Kentucky

2 days

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......

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Senior Specialist, Provider Network Admin

Molina Healthcare

Kentucky

2 days

***Remote and must live in the United States***JOB DESCRIPTIONJob SummaryProvider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims...

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VP, Payment Integrity

Molina Healthcare

Louisville, Kentucky

1 day

Job DescriptionJob SummaryThe VP, Payment Integrity position provides strategic leadership, vision, and expertise in support of the cross-functional Payment Integrity organization. It is focused on driving efficiencies, i...

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Supv, Member Services (EST hours)

Molina Healthcare

Louisville, Kentucky

1 day

JOB DESCRIPTION****This remote job position will have set hours between 8am-8pm EST Monday-Friday***Job Summary Provides customer support and stellar service to meet the needs of our Molina members and providers.......

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Program Manager (Remote)

Molina Healthcare

Louisville, Kentucky

today

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...

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Architect, Info Systems - Azure Cloud/Containers/QNXT - Remote

Molina Healthcare

Louisville, Kentucky

1 month

JOB DESCRIPTIONJob SummaryArchitects company specific systems and technology expertise across multiple infrastructure and development disciplines.Applies and promotes key principles (e.g. stability, scalability, performan...

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Specialist, Provider Contracts (Remote)

Molina Healthcare

Kentucky

1 month

JOB DESCRIPTIONJob SummaryMolina National Level Contracting jobs are responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider infor...

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Rep, Customer Experience - Inbound (Remote - Candidate MUST reside in Kentucky)

Molina Healthcare

Kentucky

22 days

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....

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Pharmacy Rep (10am-6:30pm PST M-F)

Molina Healthcare

Louisville, Kentucky

2 days

JOB DESCRIPTIONPosition is 100% remote and will work 10-6:30pm PST M-F, no weekends or holiday.Job SummaryMolina Pharmacy Services/Management staff work to ensure that Molina providers & pharmacies have access to......

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Senior Dental Provider Services Representative

Molina Healthcare

Kentucky

2 days

***Remote and must live in the United States***JOB DESCRIPTIONJob SummaryMolina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training a...

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Care Review Clinician, Inpatient Review (RN) Sun - Thurs or Tues - Sat

Molina Healthcare

Louisville, Kentucky

7 days

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Field Family Nurse Practitioner (Pikeville, KY)

Molina Healthcare

Pikeville, Kentucky

27 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...

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Member Navigator -Bilingual (English/Spanish, Chinese, Vietnamese))

Molina Healthcare

Kentucky

26 days

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......

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Director, Process Improvement & Operational Excellence (Data Governance/Informatics) - REMOTE

Molina Healthcare

Louisville, Kentucky

1 month

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...

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Pharmacy Technician (Start time between 8-10am EST M-F)

Molina Healthcare

Louisville, Kentucky

1 day

JOB DESCRIPTIONThis remote job position will have a start time between 8-10am EST M-F.Job SummaryMolina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary......

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Mgr, Physical Security

Molina Healthcare

Louisville, Kentucky

1 day

Job DescriptionJob SummaryThe Mgr, Physical Security is responsible for ensuring the safety and security of the organization's physical assets, facilities, and personnel. The manager develops, implements, and manages comp...

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Sr Consultant, Threat Management, PSOC

Molina Healthcare

Louisville, Kentucky

1 day

Job DescriptionJob SummaryAs the Senior Consultant, Threat Management PSOC, you will be a member of Molina Healthcares Protection Services Operations Center, reporting to the Manager. This role will be responsible......