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Molina Healthcare

127 đź’Ľ Jobs / Employment / Molina Healthcare

AVP, Healthcare Services

newabout 8 hours ago
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Job Description - AVP, Healthcare Services (1902262) Job Description AVP, Healthcare Services - (1902262) Primary Location : US-TX-Houston-TXHARRIS Other Locations : US-TX-Irving-TXIRV Job : Healthcare Services Organization : Health Plan…

Care Review Clinician, Prior Authorization LVN

newabout 8 hours ago
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  • Long Beach
  • CA

*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 he…

Project Coordinator (EPSDT)

newabout 8 hours ago
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Job Description Job Summary Provides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. May also perform a variety of activities …

Pharmacy Representative (M-F 10am-6:30pm)

newabout 8 hours ago
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Job Description Job Summary Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy …

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Assoc Analyst, Business System

newabout 9 hours ago
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  • Long Beach
  • CA

Job DescriptionJob SummaryAssist business teams with developing requirements for major projects of considerable complexity, prepares system design specifications, conducts research to resolve customer initiated issues related to Medicaid claims proce…

Call Center Rep (Multiple Openings)

newabout 9 hours ago
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  • Albuquerque
  • NM

*Job Summary* Provides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and serv…

Nurse Practitioner, Field (Jacksonville, FL)

newabout 9 hours ago
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  • Jacksonville
  • FL

Care Connections, our national team of Nurse Practitioners, provides in home health services for Medicare, Marketplace, and Medicaid recipients. Through our program we are able to meet our patients where they live and conduct health assessments in th…

Nurse Practitioner, Field (St. Petersburg, FL)

newabout 9 hours ago
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Care Connections, our national team of Nurse Practitioners, provides in home health services for Medicare, Marketplace, and Medicaid recipients. Through our program we are able to meet our patients where they live and conduct health assessments in th…

Dir, Healthcare Analytics

newabout 9 hours ago
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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 …

Pharmacist, Utilization Mgmt (UM)

newabout 9 hours ago
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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…

Program Manager, HCS - Los Angeles

newabout 9 hours ago
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  • Los Angeles
  • CA

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 …

Associate Business Analyst (Healthcare Claims experience required)

newabout 9 hours ago
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Job Summary * Conduct data analysis of claim data and other data collected and conduct root cause analysis/solutioning to help improve operations. * Collaborate with business leaders to deliver insights derived from data, highlighting emerging tren…

Supv, Appeals & Grievances

newabout 9 hours ago
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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 r…

Sr Specialist, Quality Improvement (RN)

newabout 9 hours ago
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  • Long Beach
  • CA

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 pre…

Delegation Oversight Nurse

newabout 9 hours ago
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  • Long Beach
  • CA

*Job Description* *Job Summary* Responsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA, CMS and State Medicaid requirements including delegati…

Sr Account Rep, Medicare - Boise

newabout 9 hours ago
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Job Summary Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability and retention goal…

Sr Program Manager - Regional HEDIS Operations (Remote in Illinois, Michigan or Wisconsin)

newabout 9 hours ago
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*Job Description* *Job Summary* Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedul…

Community Connector

newabout 9 hours ago
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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 …

AVP, Core Operations: Coordination of Benefits (COB)

newabout 9 hours ago
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  • Long Beach
  • CA

AVP, Core Operations: Coordination of Benefits (COB) - (1900916) Primary Location : US-CA-Long Beach-HUGHES Other Locations : US-WA-Spokane-SPOKANE Job : Core Operations Organization : Corporate Job Posting : Apr 23, 2019, 12:21:09 PM Addi…

LVN, Case Manager

newabout 9 hours ago
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  • Long Beach
  • CA

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…

Provider Contracts Manager

newabout 9 hours ago
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Job Description Job Summary Negotiates agreements with highly visible providers who are strategic to the success of the Plan, including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and market…

Dir, Finance

newabout 9 hours ago
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*Job Description* *Job Summary* Responsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial project…

Call Center Rep (Multiple Openings)

newabout 10 hours ago
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*Job Summary* Provides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and servi…

Pharmacist, Clinical / MTM

newabout 10 hours ago
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  • Long Beach
  • CA

Knowledge/Skills/Abilities Molina Clinical Pharmacists provide a clinical pharmacy outreach service to educate patients and their health care team in order to optimize medication related healthcare outcomes, ensure patient safety, recommend cost-effe…

Nurse Practitioner, Field (Gulf Port

newabout 10 hours ago
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Care Connections, our national team of Nurse Practitioners, provides in home health services for Medicare, Marketplace, and Medicaid recipients. Through our program we are able to meet our patients where they live and conducthealth assessments in the…

Registered Nurse

newabout 10 hours ago
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  • North Charleston
  • SC

*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 healt…

Registered Nurse

newabout 10 hours ago
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  • West Columbia
  • SC

*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 healt…

Provider Contracts Manager

newabout 10 hours ago
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*Job Description* *Job Summary* Negotiates agreements with highly visible providers who are strategic to the success of the Plan, including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and m…

Registered Nurse

newabout 10 hours ago
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*Knowledge/Skills/Abilities* Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM). Monito…

Registered Nurse

newabout 10 hours ago
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*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 healt…

Clinical Services Auditor

newabout 10 hours ago
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Knowledge/Skills/Abilities * Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM) and mo…

Associate Business Analyst (Healthcare Claims experience required)

newabout 10 hours ago
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*Job Summary* * Conduct data analysis of claim data and other data collected and conduct root cause analysis/solutioning to help improve operations. * Collaborate with business leaders to deliver insights derived from data, highlighting emerging tr…

Care Review Clinician, Prior Authorization

newabout 10 hours ago
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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…

Specialist, Appeals & Grievanc

newabout 10 hours ago
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  • 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 r…

Care Review Clinician, Inpatient Review (RN)

newabout 10 hours ago
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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…

Registered Nurse

newabout 10 hours ago
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  • Long Beach
  • CA

*Job Description**Job Summary*Responsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA, CMS and State Medicaid requirements including delegation…

Nurse Practitioner, Field (Greenville

newabout 10 hours ago
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  • Charleston
  • SC

Care Connections, our national team of Nurse Practitioners, provides in home health services for Medicare, Marketplace, and Medicaid recipients. Through our program we are able to meet our patients where they live and conducthealth assessments in the…

Medical Records Collector

newabout 10 hours ago
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*Job Description* *Job Summary* Molina's HEDIS/Quality Improvement Medical Records Collector will work collaboratively in outreaching to providers in order to pursue medical records via phone call, fax, mail, electronic medical record system retriev…

Sr Analyst, Finance

newabout 10 hours ago
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*Job Description* *Job Summary* Responsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial project…

Pharmacy Technician - Pre-Authorizations

newabout 10 hours ago
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*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 responsi…

VP, Finance & Analytics

newabout 10 hours ago
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  • Long Beach
  • CA

Knowledge/Skills/Abilities Leads the financial analysis of the health plan's performance and oversees the daily operations of Finance and Medical Data Management functions, including systems, Reporting and Analysis, Project Management Office, Facilit…

Sr Program Manager - Regional HEDIS Operations (Remote in Illinois, Michigan or Wisconsin)

newabout 11 hours ago
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*Job Description* *Job Summary* Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedul…

VP, Marketplace - Irving

newabout 11 hours ago
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Job Summary Responsible for all aspects of product development, implementation and management of health insurance marketplace products that support Molina's successful membership growth, retention and product profitability under the Patient Protect…

VP, Marketplace

newabout 11 hours ago
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Job Description - VP, Marketplace (1901565) Job Description VP, Marketplace - (1901565) Primary Location : US-TX-Irving-TXIRV Job : Health Plans Organization : Health Plans Job Posting : May 28, 2019, 10:24:26 AM Additional Information:…

Nurse Practitioner, Field (Clark County/Vancouver

newabout 11 hours ago
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Job SummaryMolina Healthcare has always been a special place to work. Founded by Dr. C. David Molina 35 years ago, the company has grown over the past few decades from a single clinic to health plans serving fifteen states. During the time of expansi…

Medical Director

newabout 11 hours ago
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  • Long Beach
  • CA

Job Description Job Summary Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provision of medical s…

Sr Rep, Enrollment

newabout 11 hours ago
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  • Long Beach
  • CA

Job Description Job Summary Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and mate…

Medicare Medical Director (Molina Healthcare)

newabout 11 hours ago
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Job ID Number: 9921 Facility Name: Molina Healthcare Location Name: Bothell, WA Brand Name: Molina Healthcare Provider Profession: Physician/Surgeon Medical Specialty: Family Medicine Medical Specialty: Internal Medicine Job Setting: Other Ty…

Specialist, Appeals & Grievances

newabout 11 hours ago
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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 r…

Assoc Rep, Member Services

new1 day ago
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Job Description Job Summary Provides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Prov…

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