Job Title Provides executive level strategy and leadership for teams responsible for optimization of clinical operations across the enterprise. Develops and implements processes to ensure healthcare services functions including utilization management/care management/etc. and clinical vendors provide
Job Title Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs.
Job Description Provides senior level 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 health plans and vendors to facilitate
Job Title Leads and manages team responsible for configuration activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan business and
Job Description Provides senior level support for all aspects of taxation including compliance, planning, forecasting, merger and acquisition (M&A) evaluation, expense, liability and asset recordation, securities and exchange (SEC) and statutory reporting disclosure, Sarbanes-Oxley (SOX) compliance,
Job Title Provides lead level support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy
