Job Title Provides non-clinical administrative support to the care management function, and contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member
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 for
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 in
Job Title Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the
Senior Program Management Professional Responsible for the management of internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets.
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 Data & Analytics
Project Controls Specialist (Hybrid) Long Beach & Los Angeles, CA What We’re Looking For: Michael Baker International is seeking a Project Controls Specialist to support project delivery across our Long Beach and Los Angeles offices. This
Description Location: Long Beach, CA (Hybrid) Job Type: Full-Time Schedule: Hybrid schedule is 2 days in-clinic 8-hour shift Monday to Friday Day Shift We are looking for a compassionate person who loves an opportunity to make
Verizon recently acquired Frontier and plans to transition non-union Frontier employees into Verizon compensation and benefits programs. This position will be part of that planned transition. Who we are: As the largest pure-play fiber provider in the
Who We Are: Since 1906, New Balance has empowered people through sport and craftsmanship to create positive change in communities around the world. We innovate fearlessly, guided by our core values and driven by the belief
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. Ensures members reach
Crop Shop Boutique (CSB) is a fast-growing Australian e-commerce brand redefining athleisure since its launch in 2019 by Rachel Dillon. With a mission to empower women worldwide, CSB blends style, function, and confidence in every piece
Claims Support Specialist Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for
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 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 internal
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 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
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 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 services in
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