Job Title This is a telephonic position and productivity is important. Job Description This RN will act as a Lead in Healthcare Services supporting our Medicaid members who have recently been admitted to this hospital. The
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 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
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 or
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,