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Molina Healthcare Jobs in Texas

125 Jobs Found

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 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 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......
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 implementing and monitoring local QI and HEDIS interventions. Essential Functions • Assists Interventions Manager in implementing provider or member interventions • Works on removing barriers to care, either at t......
Job Summary This position will be instrumental in the successful development and deployment of workforce management strategy nationwide. The ideal candidate will have the ability maintain workforce management tools and systems for Molina Healthca......
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 ......
Job Summary Reviews healthcare service delivery and provides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with all state and federal regulations and guidelines. Collaborates with th......
Job Summary Responsible for assisting in the implementation of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud, Waste and Abuse Plan across the Molina enterprise to ensure compliance with contractual and regulatory requirements. ......
Job Summary Reviews healthcare service delivery and provides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with all state and federal regulations and guidelines. Collaborates with th......
Job Summary Negotiates agreements with integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers. Essential Functions • Negotiates physician group, ancillary and facilit......
Job Summary Under minimum supervision, serves as a community based member advocate and resource and a vital part of the Integrated Molina Healthcare Care Team. Provides outreach to locate and/or provide support for disconnected members with special ......
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 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 ......
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 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 ......
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......
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, ......
Job Summary Works within the Care Access and Monitoring (CAM) team to provide clerical and data entry support for Molina Members that require hospitalization and/or utilization review for other healthcare services. Checks eligibility and verifies b......
Job Summary Responsible for overseeing the Case Management staff focused on assisting varous groups and individuals with their health care needs to achieve optimal clinical, financial and quality of life outcomes. Monitors information daily as ap......
Job Summary Leads and facilitates multidisciplinary Provider Engagement Teams (PET) working with key strategic provider partners to improve quality outcomes and Medical Care Ratios (MCR) in support of strategic business objectives. • Serves as a Pr......
Job Summary Leads and facilitates multidisciplinary Provider Engagement Teams (PET) working with key strategic provider partners to improve quality outcomes and Medical Care Ratios (MCR) in support of strategic business objectives. • Serves as......
Job SummaryUnder minimum supervision, serves as a community based member advocate and resource and a vital part of the Integrated Molina Healthcare Care Team. Provides outreach to locate and/or provide support for disconnected members with special ......
Job Summary Responsible for overseeing the Case Management staff focused on assisting varous groups and individuals with their health care needs to achieve optimal clinical, financial and quality of life outcomes. Monitors information daily as ......
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 t......