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Jobs at Molina Healthcare

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Rep, Provider Services

Molina Healthcare - Houston, TX

Job Description Job Summary Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Service...

Director, Payment Integrity

Molina Healthcare - Long Beach, CA

Job Description Job Summary Responsible for planning, developing and directing the implementation of techniques to ensure the maintenance of performance and quality levels in the Business' products and processes. Reviews operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve

Patient Access Coordinator

Molina Healthcare - Bothell, WA

Job Description Job Summary Provides support to the clinic operations by adding assistance when applicable. Helps ensure satisfaction is achieved for patients. Knowledge/Skills/Abilities • Responsible for outreach to patients assigned to particular clinics. • Contacts all identified members who visited Emergency Rooms (monthly) using a predeterm...

Sr Learning Facilitator, Medicare Appeals & Grievances

Molina Healthcare - Long Beach, CA

Job Summary Oversees all activities associated with the training and development of Medicare Appeals & Grievance staff. Leads evaluation and implementation of new training opportunities to ensure CMS compliance and improved efficiencies. Maintains and develops departmental procedural documentation. Knowledge/Skills/Abilities ...

Clerk (SIU/Compliance)

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,...

Project Manager, PMO

Molina Healthcare - Long Beach, CA

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 • Proven depth of understanding and demonstrable results for effect...

Assoc Analyst, Provider Config

Molina Healthcare - Troy, MI

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...

Analyst, Config Info Mgmt

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 adh...

Sr Architect, EIS

Molina Healthcare - Long Beach, CA

Job Description Job Summary Builds company specific systems and technology expertise across multiple infrastructure and development disciplines Knowledge/Skills/Abilities • Responsible for the Infrastructure Solution Architect project design function • Responsible solution architecture delivery within project management methodologies and timelin...

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 o...

Medical Claim Review Nurse

Molina Healthcare - Spokane, WA

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/Ski...

Transition of Care Coach

Molina Healthcare - San Diego, 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 desi...

Case Manager

Molina Healthcare - San Diego, 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 desi...

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 desi...

Specialist, Claims Recovery

Molina Healthcare - Spokane, WA

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/Ski...