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Molina_Healthcare_Inc Jobs & Careers

573 Jobs Found

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......
Job Summary Primarily responsible for leading 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 business......
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......
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 ......
Job Summary Oversees the integrated Care Access and Monitoring team responsible for prior authorizations, inpatient and outpatient medical necessity/utilization review and other utilization management activities aimed at providing 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 cop......
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......
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 ......
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 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 business obj......
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 ......
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 • Provides analytical, problem solving expertise, including: definition and documentation, specifications. Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developm......
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 ......
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 pla......
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 Responsible for intermediate to large scale 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 d......
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 in......
Job SummaryUnder general supervision, researches, analyzes and processes data relating to HR systems and/or programs, developing complex ad-hoc reporting for all levels of management. Collaborates with and supports Employee Programs and Corporate Po......
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 business obj......
Job Summary Oversees the integrated Care Access and Monitoring team responsible for prior authorizations, inpatient and outpatient medical necessity/utilization review and other utilization management activities aimed at providing 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 calls.• Ach......
Job Summary Leading, with a team, or individually, develops or modifies business requirements and functional specifications for software application and technology projects, including Business Requirements Documents (BRDs) and Functional Requirement......
Job Summary Focuses on process improvement, organizational change management, program management and other processes relative to the business.Essential Functions Active collaborator with people who are responsible for internal business projects an......
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 pla......