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Jobs at Molina Healthcare

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Rep, Provider Inquiry R&R

Molina Healthcare - Columbus, OH

Job Description Job Summary Molina Health Plan Operations jobs are responsible for the development and administration of our State health plan's operational departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provid...

Assoc Specialist, Appeals & Grievances

Molina Healthcare - Columbus, OH

Job Description Job Summary Molina Healthcare's Appeals & Grievances jobs are responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid. Knowledge/Skills/Abilities • Enters deni...

Project Coordinator

Molina Healthcare - Long Beach, CA

Job Description Job Summary Provides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. May also perform a variety of activities in support of the functional processes, programs and/or services. Also provides the administration of various programs,...

Case Management Processor

Molina Healthcare - Albuquerque, NM

Job Description Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desi...

Director, Clinical Operations

Molina Healthcare - Long Beach, CA

Job Description Job Summary The Director, Clinical Operations is responsible for the clinical operations within the Nurse Advice Outsourced Contact Center. This roll will report directly to the VP of Contact Center and will also act as an intermediary between the Chief Medical Officer and the vendor. Knowledge/Skills/Abilities • Directs Nurse Advic...

Care Review Processor

Molina Healthcare - North Charleston, SC

Job Description Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desi...

Clinical Services Auditor (RN)

Molina Healthcare - Jackson, MS

Knowledge/Skills/Abilities • Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM) and monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May also perform non-clinical system and p...

Case Manager

Molina Healthcare - Columbus, OH

Job Description Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desi...

Pharmacy Technician

Molina Healthcare - Oak Brook, IL

Job Description Job Summary Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal ...

Pharmacy Technician

Molina Healthcare - Bothell, WA

Job Description Job Summary Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal ...

Pharmacy Technician

Molina Healthcare - Irving, TX

Job Description Job Summary Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal ...

Project Coordinator

Molina Healthcare - Columbus, OH

Job Description Job Summary Provides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. May also perform a variety of activities in support of the functional processes, programs and/or services. Also provides the administration of various programs,...

Assoc Analyst, Provider Config

Molina Healthcare - Midvale, UT

Job Description Job Summary Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed o...

AVP, Medicare Product Development

Molina Healthcare - Long Beach, CA

Job Description Job Summary This position is responsible for supporting development and pricing of Medicare products, which include today MMP, D-SNP and MA-PD, with additional products on the horizon for 2020 and beyond. Knowledge/Skills/Abilities The AVP, Medicare Product Development is a key member of a national support team that is responsible f...

Complex Case Manager (RN)

Molina Healthcare - Edinburg, TX

Job Description Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desi...