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Molina Healthcare Jobs & Careers - Page 6

1000+ Jobs Found

Job Summary Under the supervision of the Clinic Supervisor and/or Administrator in the reception and medical records area of the center. Primary responsibility: To ensure all external and internal PHI (personal health information) requests for cop......
Molina Healthcare
Job Summary Under general supervision/direction, responsible for supporting various provider services functions with an emphasis on working externally with Plan’s Providers to educate, advocate and engage as valuable partners. Requires provider s......
Molina Healthcare
Job Summary Under the supervision of the Clinic Supervisor and/or Administrator in the reception and medical records area of the center. Primary responsibility: To ensure all external and internal PHI (personal health information) requests for co......
Molina Healthcare
Job Summary Provides leadership, consultation, communication and coordination of clinical informatics projects and processes for the Molina Medical Group. Projects may include, but are not limited to the following: systems implementations, intern......
Molina Healthcare
Job Summary Healthcare Analyst II is an individual contributor role that provides senior-level healthcare analysis for the state health plans, including quantification and analysis of health care costs, development and maintenance of databases an......
Molina Healthcare
Job Summary Responsible for simple to intermediate projects and project teams made up of internal and external resources to deliver business solutions and services to the department. Interacts closely with internal staff, external corporate depar......
Molina Healthcare
Job Summary Accountable for the daily operations of PIM, Contract Administration, and Provider/Member Payment Resolution Units. Assures that department, federal and state specific standards are maintained and that overall processing accuracy is a......
Molina Healthcare
Job Summary The Claims Manager is accountable for the daily operation of one or more Claims teams. They are responsible for assuring the achievement and maintenance of departmental key performance indicators as well federal and state specific req......
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 • SQL queries • MMR and TRR file analysis • 834 file analysis • Multiple third party applications that contain Molina member data (examples, case management, MTM) • Manage dedicated servers • Analyze demographic charact......
Molina Healthcare
Job Summary The Corporate Senior Accountant is responsible for the day-to-day and month-end accounting processes for the state plan to which he/she is assigned, including journal entries and account reconciliations. Essential Functions • Pr......
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 Manages the Plan’s Provider Services functions and team members. Responsible for the daily operations of the department working collaboratively with all members of the Plan’s Network Management & Operations team of Provider Services & Co......
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 det......
Molina Healthcare
Job Summary Under direct supervision, assists in the development, implementation, and administration of compensation programs. Essential Functions Evaluates salaried, hourly and middle management positions Assists in the administration of perform......
Molina Healthcare
Job Summary Responsible for supporting project management initiatives and project teams made up of internal and external resources to deliver business solutions and services to the department. Assists internal staff, external corporate department......
Molina Healthcare
Job Summary Provides medical oversight 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 pro......
Molina Healthcare
Job Summary Provides thorough software testing to ensure upgrades, enhancements and new applications function accurately. Provides software quality assurance oversight for manual and automation testing initiatives system-wide. Provides testing su......
Molina Healthcare
Job Summary The medical assistant assumes responsibility and accountability for delivery of care to clinic patients ranging from pediatric to geriatric through the use of the nursing process, the environment/instrumentation and other health care tea......
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 The medical assistant assumes responsibility and accountability for delivery of care to clinic patients ranging from pediatric to geriatric through the use of the nursing process, the environment/instrumentation and other health care tea......
Molina Healthcare
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 administrativ......
Molina Healthcare
Job Summary Under general supervision/direction, responsible for supporting various provider services functions with an emphasis on working externally with Plan’s Providers to educate, advocate and engage as valuable partners. Requires provider s......
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 calls.• Ach......
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 calls.• Ach......
Job SummaryNegotiates assigned contracts and letters of agreements with hospitals, physician groups and ancillary providers that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according......
Molina Healthcare
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 adminis......
Job Summary • Meets and consistently maintains production standards for Claims Adjudication.• Supports all department initiatives in improving overall efficiency.• Identifies and recommends solutions for error issues as it relates to pre-payment of ......
Molina Healthcare
Job Summary Responsible for providing a variety of complex administrative tasks and project support for the Quality Improvement Department including the Credentialing, Facility Site Review and HEDIS areas within the department of Quality Improvem......
Job Summary Under general direction, designs and develops software and modification enhancements to a MMIS through all phases of a system lifecycle. Contributes to the company's success through excellent customer service and meets or exceeds perform......
Job Summary The Corporate Senior Accountant is responsible for the day-to-day and month-end accounting processes for the state plan to which he/she is assigned, including journal entries and account reconciliations.Essential Functions • Preparation ......
Job Summary The Director of Risk Adjustment is a key leadership position within the Quality department. The Director is responsible for setting appropriate risk scores for Molina Medicare members and Molina Medicaid members where risk adjustment is ......