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Molina_Healthcare Jobs & Careers

1000+ Jobs Found

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......
Job Summary The Analyst a key Quality Leader for Corporate and Health Plans within the organization. The Analyst may be empowered to advise senior management and other departments on Quality strategies and initiatives. The responsible functional Qua......
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......
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......
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......
Job Summary Responsible for the development and monitoring of annual budget and comparison analysis of actual to budget variances. Position is also responsible for P4P programs as well as financials operations related to general ledger and monthl......
Job Summary Review retail level (level I) prior authorization request for approval. Interacts with other staff throughout the organization, as well as external contacts on a daily basis. Ongoing public contacts include, but are not limited to: in......
Job Summary Creates and manages the required documentation for QI Compliance. Essential Functions Conduct review and investigation of potential quality of care issues in collaboration with dedicated clinical and non-clinical health plan st......
Job Summary Provides technical direction to the team in respective areas of expertise. Explores new technologies that can be implemented in Molina which are cost effective giving a good Return on Investment (ROI). Essential Functions o Revi......
Job Summary Negotiates 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 accordin......
Job Summary This primary care physician will work in the health centers providing primary care medical care services to the patients of the Community Healthcare Network. Essential Functions Leads member of the clinical care team which cons......
Job Summary The Associate Medical Director (AMD) position is divided 50/50 with direct patient care (primary care) and administrative responsibilities as outlined below. Time is divided between centers and off site meetings, such as coordination mee......
Job Summary Drives and coordinates software license reviews and audits to ensure Molina is in compliance with all agreements. Acts as a liaison between Molina Corporate IT and Molina Procurement and assist with analyse of license metrics and......
Job Summary Responsible for the activities related to major system configuration, new health plan implementations and conversions within the Configuration Information Management (CIM) Operations and Implementation Teams. Responsible for accura......
Job Summary Directly supervises and responsible for the day-to-day performance of a team or shift. Responsible for daily administrative functions, including staffing, productivity, work quality, project and operations management. Essential Fun......
Job Summary Provides technical direction to the team in respective areas of expertise. Explores new technologies that can be implemented in Molina which are cost effective giving a good Return on Investment (ROI). Essential Functions o Revi......
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......
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 Requirem......
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 activiti......
Job Summary Plans, organizes, staffs, and coordinates the activities of the Provider Contracts unit within the MHI Provider Network Strategy & Services Department. Works with Associate Vice President MHI Provider Network Strategy & Services, Plan Pr......
Job Summary Provides technical direction to the team in respective areas of expertise. Explores new technologies that can be implemented in Molina which are cost effective giving a good Return on Investment (ROI). Essential Functions o Revi......
Job Summary Receives and reviews Medicaid rebate payments for multiple programs and to identify and resolve rebate disputes. Essential Functions o Analyzes disputed data and negotiates with drug manufacturers to fairly and accurately resolve d......
Job Summary Provides technical direction to the team in respective areas of expertise. Explores new technologies that can be implemented in Molina which are cost effective giving a good Return on Investment (ROI). Essential Functions o Revi......
Job Summary Creates, manages, and compiles the required documentation to maintain critical quality improvement functions and activities, related to Quality Improvement Compliance, Quality Reporting, Performance Measurement Operations, Interventi......
Job Summary Maintains an awareness of state and federal regulations/legislation and other governing requirements. Works on a project basis to address Molina compliance as mandated by HIPAA Security, Sarbanes Oxley Act and State & Federal Reg......
Job Summary Responsible for managing, planning and guiding Molina Healthcares technology platforms, infrastructure operations, and engineering teams across all of the companys business entities. Works closely with the CIO, CTO, IT Senior Management ......