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Jobs at Molina Healthcare

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AVP, Business Development

Molina Healthcare - Long Beach, CA

Job Description Job Summary Monitors activity in other markets that may develop into opportunities. Leads managed-care related business development activities for national, state, and local conferences, seminars, and meetings. Knowledge/Skills/Abilities • Identifies, tracks, qualifies and pursues new business opportunities in new targeted markets.

Case Manager (RN)

Molina Healthcare - Long Beach, CA

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, Config Info Mgmt-QNXT

Molina Healthcare - Long Beach, CA

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

Case Manager

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...

Case Manager (Eastern Idaho)

Molina Healthcare - Idaho Falls, ID

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...

Specialist, Appeals & Grievances

Molina Healthcare - Milwaukee, WI

Job Description Job Summary Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is 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...

Enrollment Services Rep

Molina Healthcare - Long Beach, CA

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...

Sr. Organizational Development Specialist

Molina Healthcare - Long Beach, CA

Job Description Job Summary Senior OD Specialist supports the management and delivery of leadership and organizational development services to the organization. The position will work closely with Human Resource Business Partners and our HR Centers of Expertise, as well as leaders to provide organizational development services along with leadership development strat...

Care Review Clinician, Inpatient Review (BH)

Molina Healthcare - Syracuse, NY

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, Provider Configura

Molina Healthcare - Long Beach, CA

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 on...

Manager, Finance

Molina Healthcare - Troy, MI

Job Description Job Summary Responsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial projects or programs. Duties include gathering, interpreting, and evaluating financial information; generating forecasts and analy...

Clinical Appeals Nurse - RN (remote / must reside in TX)

Molina Healthcare - Irving, TX

Job Description Job Summary Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance standards. Knowledge/Skills/Abilities • The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals request has been made or upon request b...

Analyst, Provider Configuratio

Molina Healthcare - Long Beach, CA

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 on...

Case Manager (RN)

Molina Healthcare - El Paso, 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...

Care Review Processor

Molina Healthcare - El Paso, 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...