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 laser focused
Job Title 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 improved Medicare Star ratings. Responsible
Eastman Credit Union is now hiring a Part Time Member Contact Center Specialist! Our ideal candidate will conduct themselves in a way that reflects our high standards of professionalism and customer service. These standards include excellent
Job Title Leads and supervises 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 JOB DESCRIPTION Provides support to Molina functional areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion networks, as
Technical Coordinator Provide hands on technical coordination across engineering, platform, data, security, and operations teams. Focus on troubleshooting, solution alignment, and execution support. Partner with engineers and architects to resolve issues and move work forward. Support
Job Title Provides support to Molinas Medicare segment through program management, including governance frameworks, internal and partner capability delivery oversight, program controls, playbooks and best practices, as applicable. Serves as a key interface between the Medicare
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 directs 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
Sr. Director, Member Engagement Operations Homebase Medical is getting back to basics. Our mission is to optimize the quality of life for homebound older adults, allowing them to live independently and with dignity in their own
Job Description Leads and manages team responsible for special investigation unit (SIU) activities, specifically the prevention and detection of violation of applicable laws and regulations. Responsible to protect the business from liability of fraudulent or abusive
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
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, and
Lead, Medicare Administration Molina Healthcare is hiring a Lead, Medicare Administration. This will be a remote position on our team that is responsible for our Medicare product- both Bids and Member Materials. Highly qualified candidates will
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
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
Job Title Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less advanced tier II and tier III providers have engagement plans to meet annual
Job Title Leads and supervises team responsible for provision of support center customer service excellence to meet the needs of Molina members and providers. Ensures issues and needs are addressed fairly and effectively, and in alignment
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