Job Description Job Summary Secures enterprise information by determining security requirements; planning, implementing, and testing security systems; preparing security standards, policies, and procedures; mentoring tea...
JOB DESCRIPTIONJob SummaryMolina Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall...
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 analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and sim...
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JOB DESCRIPTIONJob SummaryJob SummaryProvides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.KNOWLEDGE/SKILLS/ABILITIES P...
Job Description Job Summary Responsible for collecting, storing, processing, and analyzing large sets of data. The primary focus will be on choosing optimal solutions to use for these purposes, then......
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...
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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/SK...
JOB DESCRIPTIONJob SummaryResponsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintains the risk adjustment model, identifies risks, and estimates risk scores an...
Job DescriptionJob SummaryThe Sr Analyst, Encounters is responsible for monitoring inbound and outbound encounter processes and ensuring timely, accurate, and complete encounter submissions for moderate- to high-complexit...
JOB DESCRIPTIONJob SummaryResponsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA, CMS and State Medicaid requirem...
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 SummaryField Travel in Webster, Kossuth, Humboldt and Cerro Gordo CountiesMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan an...
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 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.....
Job DescriptionJob SummaryThe Lead Auditor, Delegation Oversight is responsible for leading and managing the auditing of complex and multi-delegated high-risk vendors. Brings all best practices together to management for ...
JOB DESCRIPTIONJOB SUMMARY (Purpose of the Job & high-level summary):Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise-wide. It is a centralized corporate funct...
JOB DESCRIPTIONJob SummaryThe Molina Healthcare Internship Program shares an objective to create a steppingstone for students and alumni who aim to be professionals and future leaders in the healthcare business......
For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN......
JOB DESCRIPTIONJob SummaryResponsible for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with the standards and re...
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