Job Description Provides senior level support for coding activities. Responsible for monitoring adherence to Molinas compliance program, minimizing risks related to coding and billing practices, and protecting the business from liability related to fraudulent/abusive practices. Performs chart reviews,
Job Title Manages team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance. Collaborates with health plans identify and track savings
Job Title Provides support for inpatient and outpatient clinical claim review activities. Job Summary Verifies that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies accurately reflect the members documented clinical condition, services rendered, and billed
Job Title Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network.