Job Description Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy
Job Description Leads and manages team responsible for health plan provider engagement activities. Collaborates with senior leadership and the health plan network team to drive value-based care strategies, and operational direction for risk adjustment and quality
Audit Support For Enterprise Risk Adjustment Provides audit support for Molina enterprise risk adjustment activities. Responsible for developing, recommending and implementing controls and cost-effective approaches to minimize the organizations risks effects. Identifies and analyzes potential sources
Sr Quality Improvement/HEDIS Specialist Molina Healthcare of Ohio is hiring for a Sr Quality Improvement/HEDIS Specialist on our Health Plan Community Interventions team. This role is remote however candidates must live in Ohio. This role is
Job Title Leads and supervises team responsible for payment integrity activities including recovery operations. Responsible for performance, quality levels and establishing procedures and techniques that achieve optimal payment integrity operational standards and production targets. Essential Job Duties
Care Manager Rn This RN will act as a Care Manager supporting our Medicaid, Medicare and Marketplace members who have recently been admitted to this hospital. The Medicaid will support them to ensure a successful transition
Job Title Molina Healthcare is hiring for a CSR for our Medication Therapy Management department. Job Description This role will be working Monday through Friday 10am to 6:30pm Mountain Standard Time. Highly qualified candidates will have
Work-From-Home Data Entry Research Panelist Join Our Team as a Work-From-Home Data Entry Research Panelist! Are you ready to earn money from the comfort of your own home? This exciting opportunity is perfect for anyone with
Job Title Claims Recovery Specialist Job Description Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider compliance. Collaborates with
Pharmacist Position Molina Healthcare is hiring a Pharmacist in our Utilization Management/Prior Auth department. This position will be working Monday through Friday from 10:00am to 6:30pm CST with rotating weekends and holidays. Candidates can be licensed
Lead Analyst Molina Healthcare is hiring for a Lead Analyst that will handle Provider and Facility Reimbursements. This team has oversight for all lines of business within our facility reimbursement scope. This team mixes some technical
Job Title Provides senior level support for Molina Physical Security enterprise applications. Job Description Provides senior level support for Molina Physical Security enterprise applications. Responsible for executing and managing the applications that support physical security operations,
Compliance Analyst Provides analyst support for compliance activities. Seeks to ensure the organization adheres to regulatory requirements, industry standards, and Molina internal policies, and prevent and/or detect violation of applicable laws and regulations, and protect the
Job Description Job Summary Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems