Care Manager RN Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to
Job Title Job Title Job Description Provides subject matter expertise in the delivery, execution and maintenance of products. Accountable for maximizing the value of assigned technical products that support enterprise operations. Owns the product vision, backlog,
Job Description 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
Actuarial Analyst Provides entry level support for actuarial function activities including extracting, analyzing, and synthesizing data from various sources to identify risks. Estimates liabilities, establishes premium rates, and supports financial analysis and reporting. Essential Job Duties
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
Senior Level Analyst Provides senior level analyst support 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 Analyzes claims,
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
Job Title Provides senior-level analytical support for medical economics initiatives, including extracting, analyzing, and synthesizing data from multiple sources. Identifies and quantifies cost-saving opportunities and communicates insights clearly in presentations to support broader understanding and adoption.
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 Investigative Support for Special Investigation Unit (SIU) Activities Job Summary Provides investigative support for special investigation unit (SIU) activities. Responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related
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
Job Title Provides support and ownership 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 compiles data
Job Description 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. Essential Job Duties Gathers, interprets and
Claims Research Analyst Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate
Job Title Provides subject matter expertise and leadership for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers
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
Job Title Job Description Job Summary 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
AVP Of Maternal & Child Clinical Operations The AVP of Maternal & Child Clinical Operations provides strategic leadership and operational oversight for enterprise-wide maternal, newborn, and child health programs. This leader ensures high-quality, equitable, evidence-based care
Job Title Leads and directs team responsible for government contracts activities. Essential Job Duties Leads and directs team responsible for management of regulatory and contractual requirements related to government programs including, but not limited to, Medicaid,
Job Description Job Summary Focuses on process improvement, organizational change management, project management and other processes relative to the business. Project management includes estimating, scheduling, costing, planning and issue/risk management. Knowledge/Skills/Abilities Ability to manage multiple complexes,