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Jobs at Molina Healthcare

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Sr Rep, Enrollment

Molina Healthcare - Louisville, KY

Job Description Job Summary The Sr Rep, Enrollment handles all processes related to membership eligibility inquiries and ensures membership accuracy within the system. Represents Enrollment Operations as a subject matter expert (SME) and works collaboratively with external clients and internal partners to resolve membership issues. Utilizes multiple applications and has deep...

Examiner, Claims

Molina Healthcare - Long Beach, CA

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 state sp...

Behavioral Health Specialist

Molina Healthcare - Long Beach, CA

Job Description Job Summary Molina's Behavioral Health Specialist provides active individualized and/or group therapy in a primary care setting which includes urgent mental health crisis intervention, chronic counseling, and community resources to manage patients' social needs. Behavioral Health Specialist will also provide continuous training and mentor...

Transition of Care Coach (RN)

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 ...

Supv, Care Management

Molina Healthcare - Springfield, 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 ...

Sr Care Review Processor

Molina Healthcare - San Antonio, TX

Job Description Job Summary Works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. Assesses members for care needs, and develops treatment plan with practitioners, providers, members and support system. Ensures quality member care is provided. Ensures patient is progr...

Lead Analyst, Healthcare Analytics

Molina Healthcare - Long Beach, CA

Job Description Job Summary Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. Knowledge/Skills/...

Assoc Analyst, Clinical Informa

Molina Healthcare - Long Beach, CA

Job Description Care Connections Tech Support Job Summary Care Connections, a division of Molina Healthcare, contributes to the company mission bringing quality health care to the underserved. The Clinical Informatics Tech Support team provides technical assistance to our 115 Care Connections Nurse Practitioners located in 14 states. The Tech Support team also off...

Administrative Assistant

Molina Healthcare - North Syracuse, NY

Job Description Job Summary Provides administrative level support to management and/or division team members. Prioritizes management/client requests in order to meet business objectives. Supports the day-to-day administrative operations of a department and/or site. Knowledge/Skills/Abilities • Provides confidential administra...

Sr Rep, Enrollment

Molina Healthcare - Louisville, KY

Job Description Job Summary The Sr Rep, Enrollment handles all processes related to membership eligibility inquiries and ensures membership accuracy within the system. Represents Enrollment Operations as a subject matter expert (SME) and works collaboratively with external clients and internal partners to resolve membership issues. Utilizes multiple applications and has deep...

Director, Corporate Development & Transformation

Molina Healthcare - New York, NY

Job Description Job Summary: This position will be responsible for supporting the execution of merger and acquisition transactions and will actively contribute in advancing Molina Healthcare's overall growth strategy. The role entails working closely with the senior members of the Corporate Development team and will actively interact with...

Member Appeals & Grievances Specialist

Molina Healthcare - Columbus, OH

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...

Specialist, Appeals & Grievances

Molina Healthcare - Long Beach, CA

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

Sr Analyst, Data

Molina Healthcare - Louisville, KY

Job Description Job Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstruct...

Rep, Customer Service 2

Molina Healthcare - Albuquerque, NM

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...