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Jobs at Molina Healthcare

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Care Review Clinician, Inpatient Review (RN)

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 desi...

Clinical Services Trainer

Molina Healthcare - Spokane, WA

Knowledge/Skills/Abilities Provides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with state and federal regulations and guidelines. Responsible for the development and implementation of training curriculum for Utilization Management, Case Management, and LTSS staff. • Responsible for evaluation of training ...

Analyst, Compliance

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise-wide. It is a centralized corporate function supporting compliance activities at individual state health plans. Knowledge/Skills/Abilities The Compliance Analyst position is primarily responsibility for supporting t...

Medical Director, Behavioral Health (Remote)

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. Knowledge/Skills/Abilities Provides Psychiatric leadership fo...

Mgr, Healthcare Analytics

Molina Healthcare - Long Beach, CA

Job Description Job Summary Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and deploying reports to provider networks and other end users for operational and strategic analysis. Knowledge/Skills/Abilities Manages and provides direct oversight of Heal...

Provider Program Manager

Molina Healthcare - Oak Brook, IL

Job Description Job Summary The Provider Program Manager is part of our innovative Enterprise Risk Adjustment Team at the Health Plan level who provides oversight of network strategies and relationship development activities for assigned providers including but not limited to: individualized planning, training and development of providers to align with Molina's Ris...

Nurse Practitioner

Molina Healthcare - Bothell, WA

Job Description Job Summary Care Connections, a division of Molina Healthcare, seeks Nurse Practitioners to join its growing team which will contribute to the company mission to bring quality health care to the underserved. The Care Connections NPs focus on screening and preventive primary care services delivered in the home, community and nursing facility settings...

Supervisor, Care Review Prior Authorization

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 ...

Examiner, Claims

Molina Healthcare - Detroit, MI

Job Description Job Summary Responsible for administering claims payments, maintaining claim records. 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/Skills/Abilities • Evaluates the adjudication of claims using standard principles and...

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/Ski...

Director, Business Architecture (REMOTE)

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 • Ability to set strategic direction from general enterprise-wide direc...

Transition of Care Coach (RN)

Molina Healthcare - Spokane, 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 desi...

Specialist, Provider Contracts

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...

Supv, Member Services

Molina Healthcare - Irving, TX

Job Description Job Summary Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences.

Care Review 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 ...