Claims Casualty Adjuster Job Summary The Claims Casualty Adjuster handles low to moderate-complexity claims involving material damage, property, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements.
Medicare Stars Quality Improvement Program Manager Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiatives and education programs to support
Job Title Provides senior level support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes Uses a consultative approach emphasizing physician engagement and behavior change through actionable
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 Leads and manages team responsible for process improvement initiatives that result in operational efficiencies and/or increase customer satisfaction. Assists in development of enterprise process improvement methodologies and the implementation of business process improvement capabilities.
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
Job Description Molina Healthcare is hiring for several Pharmacy Customer Service Representatives. These positions are remote, however those in later time zones are encouraged to apply. This team handles the Pharmacy UM / Prior Authorization calls
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
Medical Coding Specialist Provides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective
Job Title Provides senior level support for Molina enterprise quality improvement abstraction activities. Job Description Provides senior level support for Molina enterprise quality improvement abstraction activities. Responsible for data collection and abstraction of medical records for
Job Title Provides analyst support for delegation oversight activities including monitoring delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements. Responsible for gathering, coordinating, analyzing, and processing compliance
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 Description Provides senior level support for Molina Protection Services Operations Center (PSOC) enterprise applications. Responsible for executing and managing the applications that support physical security operations, business continuity management, crisis management, emergency response, and health
Delegation Oversight Manager Leads and directs team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements. Collaborates closely with
Job Title Provides senior level support for marketing and communications operations activities across the Molina enterprise. Job Description Supports the development and maintenance of marketing and communications workflows, campaign schedules, and projects, and ensures successful media
Job Title Provides analyst support for financial analysis activities including data/text mining, analysis, modeling, and predicting to understand business issues, develop solutions and enable informed business decisions. Essential Job Duties Extracts and compiles information from large
Compliance Auditor Provides support for compliance auditing activities. Responsible for evaluating Molinas adherence to regulatory requirements, internal policies, and health care industry standards by identifying compliance gaps and recommending improvements to mitigate risk related to fraudulent
Job Title Leads and directs a team responsible for financial analysis activities across designated business areas - focusing on operational performance and strategic partnerships. Facilitates analysis, modeling, and forecasting to uncover business insights, develop data-driven solutions,
Job Title Provides senior level analyst support for finance activities including financial analysis, reporting, forecasting, trending and modeling to support planning for future business decisions for the Kentucky Health Plan. Job Summary Provides senior level analyst
Job Title Provides senior level support for delegation oversight activities. Oversees delegated activities to ensure compliance with state, federal, contractual, National Committee for Quality Assurance (NCQA), and Molina requirements. Essential Job Duties Under general leadership supervision,