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Molina Healthcare Jobs & Careers - Page 2

1000+ Jobs Found

Molina Healthcare
Job Summary Applies software engineering methods and techniques to the design and development of a web portal application in C# and ASP .NET. Provides recommendations for application and system improvements. Works well independently and in a team en......
Molina Healthcare
Job Summary Manages the day to day integrated team of health plan based staff responsible for cost effective delivery of healthcare services for Molina members. Oversees staff responsible for establishing clinical, financial and educational goals......
Molina Healthcare
Job Summary Provide telephone, clerical and data entry support for the Molina Healthcare Services Case Management Team. Supports Case Management and Long Term Care Staff for all non-clinical functions. Facilitates coordination of medical services......
Molina Healthcare
Job Summary Responsible for safely and effectively transitioning Molina members from acute or inpatient care to lower levels of care and/or home in a cost efficient manner. Provides assessment, planning, implementation, coordination, monitoring, ......
Molina Healthcare
Job Summary Provides cross functional application support and development of an application or application. Essential Functions Duties and Responsibilities (List all essential duties and responsibilities in order of importance) Administ......
Molina Healthcare
Job Summary Primarily responsible to lead the design, development, testing and implementation of custom software applications and off the shelf technologies. Essential Functions Develops software (hands on code development) to meet key bus......
Molina Healthcare
Job Summary Responsible for health care management and coordination of Molina Healthcare members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative ......
Molina Healthcare
Job Summary The Nurse Practitioner may be required to work a variety of settings (non-clinical or clinical settings) and provide medical care to all levels of patients. Some programs/clinics may focus on specific populations (e.g., adult, geriatr......
Job Summary Provides management of the Core Systems development teams. Applications included are membership/eligibility, provider, claims, capitation, HR, finance, medical management and call center. Responsible for the full spectrum of applicatio......
Molina Healthcare
Job Summary Responsible for supporting service coordination activities and functions for the STAR+PLUS population in accordance with Molina policies, procedures, processes and contractual agreement with Health and Human Services Commission (HHSC)......
Job Summary Responsible for leading/overseeing multiple projects and project teams implementing projects of various sizes (scale), complexity, and duration to deliver business solutions and services to the organization. Alternatively, responsible f......
Job Summary The primary care physician will work in the health centers providing primary medical care services to the patients.Essential Functions • Acts as member of the clinical care team which consists of a physician, PA, MA and administrative su......
Job Summary Provides management of business analysts and developers for an enterprise set applications. Responsibilities include application software support and development for both custom and ‘off-the-shelf’ technologies.Essential Functions • Sup......
Molina Healthcare
Job Summary Respond to telephone inquiries from both Molina Members and Providers and provide accurate, efficient, and courteous service. Essential Functions • Respond to incoming calls from members and providers excluding provider claims c......
Molina Healthcare
Job Summary Responsible for safely and effectively transitioning Molina members from acute or inpatient care to lower levels of care and/or home in a cost efficient manner. Provides assessment, planning, implementation, coordination, monitoring, ......
Molina Healthcare
Job Summary Resolves Provider Reconsideration Requests (PRR) from providers relating to claims payment and requests for claim adjustments. Researches claims processing guidelines, provider contracts, fee schedules and system configurations to determ......
Molina Healthcare
Job Summary Provide support for preparation of various monthly reports used for month-end close and IBNR calculations. Provide support to actuaries to perform monthly IBNR estimate by state. Document assumptions and analyzes results to identify earl......
Molina Healthcare
Job Summary Respond to telephone inquiries from both Molina Members and Providers and provide accurate, efficient, and courteous service. Essential Functions • Respond to incoming calls from members and providers including provider claims c......
Molina Healthcare
Job Summary Handles written response to all incoming correspondence, appeals and complaints, from members and outside agencies. Creates weekly statistical reports and prepares Appeal Hearings folders. Essential Functions • Generates, proces......
Molina Healthcare
Job Summary Responsible for overall leadership in the strategic development and administration of contracts with the state and/or federal government for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care ......
Molina Healthcare
Job Summary • Develops and executes strategic campaigns from start to finish • Develops creative elements needed to support campaigns including but not limited to, web pages, emails, podcasts, videos and printed materials. • Assists the Dir......
Molina Healthcare
Job Summary • Ensures execution of claim handling strategies; including appropriate determination of coverage, processing guidelines and metrics. • Coordinates work flow and staffing of day-to-day activities as well as assigns and monitors wor......
Molina Healthcare
Job Summary Under supervision, works collaboratively with Molina Members and the interdisciplinary healthcare team to assess, plan , coordinate and provide education and individualized, person-centered care to achieve optimal clinical, financial ......
Molina Healthcare
Job Summary Responsible for planning, coordinating and managing the computer system infrastructure. Installs software and hardware, manages team members, and maintains various systems and security. Leads a team of systems administrators as well a......
Molina Healthcare
Job Summary Works as a liaison between Management and Staff, enacting policies and procedures to ensure optimal service is provided to Molina’s Members and Providers. Supervisors compile and analyze team data to identify trends and opportunities ......
Molina Healthcare
Job Summary Provide direct transaction and analytical support as well as research and analyses that will enhance and expand our knowledge of economic, market, industry and peer group information, trends and events to enable the Growth and Corpora......
Molina Healthcare
Job Summary Responsible for overall leadership in the strategic development and administration of contracts with the state and/or federal government for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care ......
Molina Healthcare
Job Summary Point of contact for submission/resolution of Provider Disputes and/or Member Appeals Resolutions. Assesses and completes appropriate documentation for tracking/trending data. Conducts all pertinent research in order to evaluate, resp......
Molina Healthcare
Job Summary Handles elevated/complex calls and respond to team members questions regarding incoming calls. Train new employees in the Call Center. Responds to providers with complex issues within expected response time. Provides leadership for th......
Job Summary Under general supervision, responds to user complaints to resolve problems associated with the organization’s telecommunications networks (voice and/or data). Diagnoses problem source through discussions with users. Coordinates with in......
Job Summary Works with the Utilization Management team and is primarily responsible for prior authorizations. According to guidelines provides inpatient and outpatient medical necessity/utilization review and other utilization management activities ......