Molina Healthcare Jobs - Page 6 | CareerArc

Jobs at Molina Healthcare - Page 6

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Assoc Analyst, Provider Config

Molina Healthcare - Columbus, OH

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...

Assoc Analyst, Provider Config

Molina Healthcare - Columbus, OH

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...

Sr Medical Director, Clinical Policy (Remote)

Molina Healthcare - United States of America

Job Description Job Summary The Senior Medical Director Clinical Policy is responsible for composing, maintaining and clarifying the pure clinical and clinical components of payment policies nationwide for Molina Healthcare. This role acts as a liaison between employees and the company with regard to company guidelines. In addition, this role introduces the company...

Assoc Analyst, Provider Config

Molina Healthcare - Columbus, OH

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...

Director, Medicare Administration

Molina Healthcare - Long Beach, CA

Job Description Job Summary: Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare/MMP products in support of strategic and corporate business objectives. Develops infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strateg...

Care Review Clinician, Inpatient Review (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...

Customer Service Rep (Multiple Openings)

Molina Healthcare - Irving, TX

Job Description Job Summary Provides new members with a call at predetermined intervals from their effective date with the plan to explain plan services and benefits to them. Provides product and service information to members, identifies opportunities to maintain and increase member relationships and engagement. Recommends and implements programs to support member...

Sr Specialist, Community Engagement

Molina Healthcare - Troy, MI

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...

Dir, Healthcare Services

Molina Healthcare - Louisville, KY

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. Analyst, Data

Molina Healthcare - Long Beach, CA

Job Description Job Summary Working within Enrollment Operations the Sr. Data Analyst will be responsible for data mining to solve and predict business issues within enrollment finance and enrollment operations. Technologies include SQL, SSIS, SSRS, PowerBI and Visual Studio. Designs and implements processes and solutions associated with a wide variety of data set...

Chief Medical Officer, Health Plan

Molina Healthcare - Louisville, KY

Knowledge/Skills/Abilities • Provides leadership to the health plan in the areas of strategic planning, strategy execution and implementation of care management programs, including such programs as Quality Improvement, Utilization Management, Care Management, Predictive Modeling, and Disease Management. • Leads the health plan's analysis of medical care cost and utilization dat...

Medical Director, Behavioral Health

Molina Healthcare - Louisville, KY

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...

Medical Director, Health Plan

Molina Healthcare - Louisville, KY

Knowledge/Skills/Abilities Provides medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to Plan members, targeting improvements in efficiency and satisfaction for patients and providers, as well as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding ...

Pharmacy Director

Molina Healthcare - Louisville, KY

Job Description Job Summary Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal ...

Dir, Provider Network Mgmt & Ops

Molina Healthcare - Louisville, KY

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...