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Jobs at Molina Healthcare

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Care Review Clinician, Prior Authorization

Molina Healthcare - San Antonio, 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...

Actuarial, Analyst

Molina Healthcare - Fairfax, VA

Job Description Job Summary: Responsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Knowledge/Skills/Abilities: • Collaborate with Actuarial staff to perform IBNR estimates and rate adequacy studies. Document assumptions. ...

Sr Analyst, Clinical Quality Interventions- HEDIS/QARR

Molina Healthcare - Syracuse, NY

Job Description Job Summary Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activitie...

Sr. Abstractor, HEDIS/Quality Improvement

Molina Healthcare - Midvale, UT

Job Description Job Summary Molina's Quality Improvement Sr. Abstraction team functions to conduct data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction team will meet chart abstraction productivity standards as well as minimum over read standards. Knowledge/Skills/Abil...

Case Manager, LTSS

Molina Healthcare - Cincinnati, 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...

Sr Learning Facilitator

Molina Healthcare - Irving, TX

Job Description Job Summary Analyzes and determines training needs and problems. Develops, administers and implements all training programs in accordance with the Business' initiatives and strategies. Conducts special courses designed for training selected groups of employees. Knowledge/Skills/Abilities • Consults with organizational leadership in ...

Sr 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...

Case Management Processor

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 desi...

Case Manager (RN)

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...

Director, Policy - Regulatory Affairs & Healthcare Experience Required (REMOTE)

Molina Healthcare - United States of America

Job Summary: The Director has responsibility to identify key issues in current Molina Healthcare markets and draft Molina policy initiatives aimed at passing healthcare reforms that would ensure sustainable funding for government-sponsored programs, expansion of those programs, and private-sector participation in the programs.The Director will also be responsible for reviewing...

Care Connections Rep

Molina Healthcare - Long Beach, CA

Job Description Job Summary Care Connections, a division of Molina Healthcare, seeks Outreach Agents to join its growing team which will contribute to the company mission to bring quality health care to the underserved. The Care Connections Representative primary focus is to conduct outbound calls to Molina members and schedule appointments with our Nurse Practitio...

Care Connections Rep

Molina Healthcare - Long Beach, CA

Job Description Job Summary Care Connections, a division of Molina Healthcare, seeks Outreach Agents to join its growing team which will contribute to the company mission to bring quality health care to the underserved. The Care Connections Representative primary focus is to conduct outbound calls to Molina members and schedule appointments with our Nurse Practitio...

Sr. Network Engineer, EIS

Molina Healthcare - Long Beach, CA

Job Description Plan, design, and implement Multi Cloud network systems, including configurations and support. Independently troubleshoot network issues and investigate underlying problems. Coordinate with vendors for the installation of required items, to include Cisco Routers, Switches and Firewalls. Evaluate and implement changes in conjun...

Community Engagement Specialist (Racine/Kenosha County)

Molina Healthcare - Milwaukee, WI

Job Description Job Summary Responsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages. Knowledge/Skills/Abilities • Under limited supervision, responsible f...

Community Engagement Specialist (Brown County)

Molina Healthcare - Milwaukee, WI

Job Description Job Summary Responsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages. Knowledge/Skills/Abilities • Under limited supervision, responsible f...