Provider Data Jobs In Long - 41 Job Positions Available

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 knowledge

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 quality

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 data and

Business Analyst, Provider Network Molina Healthcare is hiring for a Business Analyst, Provider Network. Highly qualified candidates will have the following experience: Salesforce knowledge, a certification is helpful Managed Care / Healthcare experience in the Provider space. Business Operations

Job Title Job Description Provides entry level analyst support for provider configuration activities including accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data within multiple claims systems and validates data stored within provider databases -

Job Title Leads and directs team responsible for health plan provider network contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Collaborates with senior leadership and the corporate network management

Job Title Investigative Support For Special Investigation Unit (SIU) Activities Job Description Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health

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 Description Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to provider networks and other end users for operational and strategic analysis. Manages and

Job Description Provides subject matter expertise consultancy and leadership for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance. Essential Job Duties Extracts and

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 system

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.

Risk & Quality Performance Manager The Risk & Quality Performance Manager position will support Molinas Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage

Job Description Provides support for provider denial coding dispute activities. Investigates and resolves disputes related to provider appeals, and ensures that claims adhere to correct billing standards and regulations. Essential Job Duties Reviews coding-related provider claims denials by systematically