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Jobs at Molina Healthcare

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Analyst, Healthcare Analytics

Molina Healthcare - Louisville, KY

Job Description Job Summary Performs research and analysis of complexhealthcare claims data, pharmacy data, and lab data regarding networkutilization and cost containment information. Evaluates, writes, and presentshealthcare utilization and cost containment reports and makes recommendationsbased on relevant findings. Knowledge/Skills/Abilities • Develop ad-hoc rep...

Sr Account Rep, Medicare

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability and retention goals, while following ethical sales practices and adhering to established policies and procedures.

Care Review Processor

Molina Healthcare - Doral, FL

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 desir...

Sr Analyst, Implementation -RN

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for strategic implementations and integrations to develop or modify highly complex requirements, plan and implement work products, contribute to the test scenario process, review UAT testing results and transition knowledge. Works with existing departments to evaluate, research and author business requirements to meet contract...

Pharmacy Internal Monitor

Molina Healthcare - Long Beach, CA

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 a...

Rep, Provider Inquiry R&R

Molina Healthcare - Oak Brook, IL

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. Provide...

Architect, Cloud Infrastructure

Molina Healthcare - Long Beach, CA

Job Description Job Summary Partners with IT colleagues to develop, migrate and deploy key cloud initiatives, while also ensure stability, functionality, and SLA requirements from the business. The cloud infrastructure engagements will focus on but not limited to infrastructure design, high availability, disaster recovery, security, compliance, performance, and cost...

Lead, Outbound Services

Molina Healthcare - Irving, TX

Job Description Job Summary This individual has overall responsibility to meet and exceed set performance for themselves on a monthly basis. The Team Lead will also help the Supervisor achieve the key performance objectives set for the outbound services team as a whole. The Team Lead will also be responsible for management of the team when the Supervisor is out. ...

Care Review Clinician, Inpatient Review (RN) M-F and some weekends REMOTE

Molina Healthcare - Oak Brook, IL

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 desir...

Case Management Processor

Molina Healthcare - Bothell, WA

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 desir...

Lead, Core Ops

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards. Knowledge/Skil...

Supv, Long Term Services & Supports (LTSS)

Molina Healthcare - Oak Brook, IL

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 desir...

Case Manager (RN)

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 desir...

Correspondence Processor

Molina Healthcare - Irving, 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 desir...

Rep, Enrollment Services 1

Molina Healthcare - Irving, TX

Job Description Job Summary Contacts members whose membership with a Molina Health Plan will terminate to help retain them as members. Assists members by providing information on how to maintain eligibility and how to ensure continued enrollment with a Molina Plan. Surveys members on reasons they are leaving their Molina Health Plan. Assist potential members with un...