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 Duties Responsible for all Member and Provider Services, including Workforce Management, Reporting, Data & Analytics, Quality Assurance, Business Solutions, Vendor Performance and Telephony across Medicaid, Medica...
JOB DESCRIPTIONJob SummaryMolina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the compan...
Job DescriptionJob Description****This job position will work EST business hours******Job SummaryThe Analyst, Encounters is responsible for monitoring inbound and outbound encounters processes and ensuring timely, accurat...
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Job SummaryThis Program Director is responsible for managing the Marketplace provider contracting process for Molina Healthcare in the Western regions (ie. CA, WA, NV, AZ). The Marketplace Program Director leads......
Job DescriptionJob SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mis...
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 SummaryThe Marketplace Operations Manager plays a key role in the oversight and strategic development of the Marketplace operations. Responsible for providing subject matter expertise for an array of......
Job DescriptionJob SummaryAVP, HP Engagement & Performance is responsible for contributing to the strategic planning and performance improvement direction for all markets assigned.Serves as a thought leader/partner to...
Job Description Job SummaryMolina's Quality Improvement Overread conducts oversight and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collec...
Job DescriptionJob SummaryThis role is not a IT-focused Security Operations (SOC) threat monitoring, incident identification and investigation activity. This role will support the overall cyber response program, which is ...
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 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 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 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...
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 Description Job Summary Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sendi...
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'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 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......
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