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Jobs at Molina Healthcare

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RN, Case Manager

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 desi...

Pediatric Case Manager (RN) - Pierce County

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 desi...

Clinical Appeals Nurse (RN)

Molina Healthcare - Midvale, UT

Job Description Job Summary Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance standards. Knowledge/Skills/Abilities • The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals request has been made or upon request ...

Care Review Clinician, Inpatient Review (RN)

Molina Healthcare - Midvale, UT

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 (Multiple Openings - San Antonio)

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...

VP, Core Operations

Molina Healthcare - Long Beach, CA

Knowledge/Skills/Abilities VP of Corporate Operations is responsible for the strategy, design, and implementation of companywide initiatives impacting Enrollment, Premium Billing and Reconciliation for all lines of business. Identifies, develops and trains appropriate staff and implements processes to standardize the overall end-to-end p...

Medical Assistant

Molina Healthcare - Long Beach, CA

Job Description Job Summary Maximizes patient care and satisfaction by interacting with the staff, patients, and providers. Provides necessary patient care when applicable to impacted individuals on the basis of living a healthy life. Knowledge/Skills/Abilities • Responsible for performing patient oriented procedures under the clinical supervision ...

Cloud Security Architect (Azure)

Molina Healthcare - Long Beach, CA

At Molina, we're looking for a Cloud Security Architect to ensure cloud solutions are deployed in a secure framework according to industry standards. We have a fast-changing and dynamic IT environment. A good candidate is someone who has the “big picture” and can also drill down to the deployment level. Primary Duties Advise on securi...

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...