NewSenior Analyst, Healthcare Molina HealthcareSenior Analyst, HealthcareDallas, TX$54,922–$107,099 / yearRegisted Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. • Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
NewSenior Analyst, Healthcare Molina HealthcareSenior Analyst, HealthcareEdinburg, TX$54,922–$107,099 / yearRegisted Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. • Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
NewSenior Analyst, Healthcare Molina HealthcareSenior Analyst, HealthcareSan Antonio, TX$54,922–$107,099 / yearRegisted Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. • Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
Specialist, IRIS Consulting (St. Croix County, WI, Pierce County, WI, & Dunn County, WI) Molina Healthcare IncSpecialist, IRIS Consulting (St. Croix County, WI, Pierce County, WI, & Dunn County, WI)New Richmond, WIRemoteBeing a liaison between the Fiscal Employer Agency and the IRIS Consultant Agency is also a large part of the position, which includes assisting participants with provider billing, seeking support brokers, tracking receipts, ensuring their workers are paid and mitigating areas of potential risk or conflicts of interest. At least 2 years experience in health care, preferably in care coordination, and at least 1 year of experience serving target groups of the IRIS program (adults with intellectual/physical disabilities or older adults), or equivalent combination of relevant education and experience.
IRIS Self-Directed Personal Care (RN) (Milwaukee County, WI) Molina Healthcare IncIRIS Self-Directed Personal Care (RN) (Milwaukee County, WI)Milwaukee, WIRemoteIRIS SDPC RNs are responsible for administering the Wisconsin Personal Care Screening Tool; creating person-centered plans of care; providing personal care oversight to a group of people in IRIS, providing education and training for IRIS participants and care providers, and conducting the required documentation and follow-up. At least 2 years nursing experience, and at least 1 year of experience serving the target groups of the IRIS program (adults with physical/intellectual disabilities or older adults), or equivalent combination of relevant education and experience.
Care Manager, LTSS - Field travel in Rock County, WI Molina Healthcare IncCare Manager, LTSS - Field travel in Rock County, WIRock County, WIAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Care Manager, LTSS - O''Fallon, IL Molina Healthcare IncCare Manager, LTSS - O''Fallon, ILO'Fallon, ILAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Analyst, Business Molina Healthcare IncAnalyst, BusinessCleveland, OHCommunicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials.
Care Manager, LTSS - Field travel in Rock County, WI Molina Healthcare IncCare Manager, LTSS - Field travel in Rock County, WIBeloit, WIAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Supervisor, Healthcare Services Molina Healthcare IncSupervisor, Healthcare ServicesFLRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 5 years health care experience, and at least 2 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
Care Manager, LTSS - Field travel in Rock County, WI Molina Healthcare IncCare Manager, LTSS - Field travel in Rock County, WIJanesville, WIAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Care Manager, LTSS - Must live in OH Molina Healthcare IncCare Manager, LTSS - Must live in OHOHAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Senior GenAI Engineer/Data Scientist / Remote Molina Healthcare IncSenior GenAI Engineer/Data Scientist / RemoteUTRemote6 plus years work experience as a data scientist preferably in healthcare environment but candidates with suitable experience in other industries will be considered •Knowledge of big data technologies (e.g., Hadoop, Spark) •Familiar with relational database concepts, and SDLC concepts •Demonstrate critical thinking and the ability to bring order to unstructured problems •Technical Proficiency: Strong programming skills in languages such as Python and R, and experience with machine learning frameworks like TensorFlow, Keras, or PyTorch. You will work at the intersection of LLMs, systems engineering, and applied ML, building intelligent agents that reason, plan, interact with tools, and operate reliably in real-world environments-particularly across regulated domains such as healthcare.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)Mount Pleasant, SCRequests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)St Petersburg, FLRequests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
Care Manager, LTSS - Polk County Molina Healthcare IncCare Manager, LTSS - Polk CountyDes Moines, IAAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
NewAssociate Analyst, Actuarial - REMOTE Molina Healthcare IncAssociate Analyst, Actuarial - REMOTERemoteProficient in Microsoft Office suite products, including key skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency. Analyze risk score results to calculate financial impact and identify trends or other issues related to risk scores.
NewAssociate Program Manager, Process & Performance Monitoring, Managed Care (Remote in FL Preferred) Molina Healthcare IncAssociate Program Manager, Process & Performance Monitoring, Managed Care (Remote in FL Preferred)FLRemoteThis team will need to coordinate with service providers, UM and CM network finance teams, and case management, assimilating and communicating information from various sources to ensure effective service delivery and compliance. Soft Skills Requirements: Key soft skills include cross-functional coordination, the ability to command a room and own their space and maintaining collaboration and organization across teams.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)Cleveland, OHRequests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
Specialist, Functional Screening- Hybrid - Must reside in Milwaukee WI, Molina Healthcare IncSpecialist, Functional Screening- Hybrid - Must reside in Milwaukee WI,Milwaukee, WIAttends meetings and training as needed or required to maintain knowledge of agency processes, the LTCFS tool, and/or any changes to process or the screening tool resulting from new state directives. Job Summary: Provides support for long-term care screening processes and coordination for older adults and adults with physical or intellectual disabilities.
Specialist, Health Plan Provider Engagement (Remote in MS) Molina Healthcare IncSpecialist, Health Plan Provider Engagement (Remote in MS)Jackson, MSRemoteDrives provider participation in Molina risk adjustment and quality efforts (e.g., supplemental data, electronic medical record (EMR) connection, clinical profiles programs) and use of the Molina provider collaboration portal. Drives provider partner coaching and collaboration to improve Medicaid, Medicare and Marketplace quality performance and risk adjustment accuracy through consistent provider meetings, action item development, and execution.
Care Manager, LTSS (LSW) - Allen County Molina Healthcare IncCare Manager, LTSS (LSW) - Allen CountyOHAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Transition of Care Coach (RN) - King/Pierce County, WA Molina Healthcare IncTransition of Care Coach (RN) - King/Pierce County, WAPierce County, WAEducates and supports member focusing on seven primary areas (Transition of Care Pillars): medication management, use of personal health record, follow-up care, signs and symptoms of worsening condition, nutrition, functional needs and or home and community-based services, and advance directives. Follows member throughout a 30 day program that starts at hospital admission and continues oversight through transitions from acute setting to all other settings, including nursing facility placement/private home, with the goal of reduced readmissions.
Care Manager, LTSS Molina Healthcare IncCare Manager, LTSSMadison, WIAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Care Manager, LTSS (BH Licensed) - LSW Molina Healthcare IncCare Manager, LTSS (BH Licensed) - LSWOHAt least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Health Plan Provider Relations Manager (North Central Florida) Molina Healthcare IncHealth Plan Provider Relations Manager (North Central Florida)Tampa, FLPerforms an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.). Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
Care Manager, LTSS (LSW) - Allen County Molina Healthcare IncCare Manager, LTSS (LSW) - Allen CountyOHAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Health Plan Provider Relations Manager (North Central Florida) Molina Healthcare IncHealth Plan Provider Relations Manager (North Central Florida)Panama City, FLPerforms an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.). Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
Specialist, IRIS Consulting Molina Healthcare IncSpecialist, IRIS ConsultingGreenfield, WIRemoteBeing a liaison between the Fiscal Employer Agency and the IRIS Consultant Agency is also a large part of the position, which includes assisting participants with provider billing, seeking support brokers, tracking receipts, ensuring their workers are paid and mitigating areas of potential risk or conflicts of interest. At least 2 years experience in health care, preferably in care coordination, and at least 1 year of experience serving target groups of the IRIS program (adults with intellectual/physical disabilities or older adults), or equivalent combination of relevant education and experience.
Care Manager, LTSS (RN) - Field travel in Milwaukee County, WI Molina Healthcare IncCare Manager, LTSS (RN) - Field travel in Milwaukee County, WIWauwatosa, WIAt least 2 years experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential.
Specialist, Health Plan Quality Practice Transformation Molina Healthcare IncSpecialist, Health Plan Quality Practice TransformationReno, NVAt least 2 years of experience improving provider quality performance through provider engagement, practice transformation, and/or managed care quality improvement initiatives, or equivalent combination of relevant education and experience. Drives engagement to ensure assigned tier II and tier III providers have practice transformation plans in place carried out to meet annual quality and risk adjustment performance goals.
Care Manager, LTSS - Story County Molina Healthcare IncCare Manager, LTSS - Story CountyAmes, IAAt least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Senior GenAI Engineer/Data Scientist / Remote Molina Healthcare IncSenior GenAI Engineer/Data Scientist / RemoteTXRemote6 plus years work experience as a data scientist preferably in healthcare environment but candidates with suitable experience in other industries will be considered •Knowledge of big data technologies (e.g., Hadoop, Spark) •Familiar with relational database concepts, and SDLC concepts •Demonstrate critical thinking and the ability to bring order to unstructured problems •Technical Proficiency: Strong programming skills in languages such as Python and R, and experience with machine learning frameworks like TensorFlow, Keras, or PyTorch. You will work at the intersection of LLMs, systems engineering, and applied ML, building intelligent agents that reason, plan, interact with tools, and operate reliably in real-world environments-particularly across regulated domains such as healthcare.
Field Nurse Practitioner (Phoenix, AZ) Molina Healthcare IncField Nurse Practitioner (Phoenix, AZ)Phoenix, AZProvides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel most comfortable, including in-home, community and nursing facilities and "pop up" clinics. Orders/performs pertinent diagnostic laboratory and radiology testing for the medical diagnosis or presenting symptoms; works within an environment of limited resources and therefore uses diagnostic tests judiciously and appropriately.
Senior GenAI Engineer/Data Scientist / Remote Molina Healthcare IncSenior GenAI Engineer/Data Scientist / RemoteFLRemote6 plus years work experience as a data scientist preferably in healthcare environment but candidates with suitable experience in other industries will be considered •Knowledge of big data technologies (e.g., Hadoop, Spark) •Familiar with relational database concepts, and SDLC concepts •Demonstrate critical thinking and the ability to bring order to unstructured problems •Technical Proficiency: Strong programming skills in languages such as Python and R, and experience with machine learning frameworks like TensorFlow, Keras, or PyTorch. You will work at the intersection of LLMs, systems engineering, and applied ML, building intelligent agents that reason, plan, interact with tools, and operate reliably in real-world environments-particularly across regulated domains such as healthcare.
Director, Data Governance (Enterprise Clinical Data Strategy & Governance) - REMOTE Molina Healthcare IncDirector, Data Governance (Enterprise Clinical Data Strategy & Governance) - REMOTECARemoteJob Summary: Develop and oversee enterprise clinical data management strategy and governance activities to optimize payer-provider clinical digital data exchanges for completeness, accuracy, and regulatory compliance while maximizing efficiency and value to Molina Healthcare and our providers. Purpose: This initiative establishes an enterprise-level strategy and governance model to address fragmented payer-to-provider clinical digital data exchanges that no single Molina function can solve independently.
Care Manager, LTSS (RN) - Field travel in Milwaukee County, WI Molina Healthcare IncCare Manager, LTSS (RN) - Field travel in Milwaukee County, WIMilwaukee, WIAt least 2 years experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential.
Care Manager, LTSS (LSW) - Southwest Ohio Molina Healthcare IncCare Manager, LTSS (LSW) - Southwest OhioHamilton, OHDevelops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
Field Nurse Practitioner (2 locations available: Tampa and Miami FL) Molina Healthcare IncField Nurse Practitioner (2 locations available: Tampa and Miami FL)Miami, FLProvides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel most comfortable, including in-home, community and nursing facilities and "pop up" clinics. Orders/performs pertinent diagnostic laboratory and radiology testing for the medical diagnosis or presenting symptoms; works within an environment of limited resources and therefore uses diagnostic tests judiciously and appropriately.
Care Manager, LTSS - RNs OR Exp. Care Managers - Local Travel Required Molina Healthcare IncCare Manager, LTSS - RNs OR Exp. Care Managers - Local Travel RequiredIAAt least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential.
Representative, Pharmacy Molina Healthcare IncRepresentative, PharmacyCAAbility to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes.
Care Manager, LTSS (RN) Molina Healthcare IncCare Manager, LTSS (RN)New Richmond, WIAt least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Analyst, Business - SQL (Remote in Florida) Molina Healthcare IncAnalyst, Business - SQL (Remote in Florida)FLRemoteCommunicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials.
Care Manager, LTSS (RN) - Field travel in Racine County, WI Molina Healthcare IncCare Manager, LTSS (RN) - Field travel in Racine County, WIRacine, WIAt least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Analyst, Business - SQL (Remote in Florida) Molina Healthcare IncAnalyst, Business - SQL (Remote in Florida)FLRemoteCommunicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials.
Pharmacist, Utilization Management/Prior Auth (Remote) Molina Healthcare IncPharmacist, Utilization Management/Prior Auth (Remote)RemoteAt least 3 years of experience in a pharmacy, Pharmacy Benefit Manager(PBM), formulary, and/or managed care setting, and 1-2 years post-graduate experience, or equivalent combination of relevant education and experience. Contributes to projects aimed at improving STAR ratings, Healthcare Effectiveness Data Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Services (CAHPS), and other quality metrics.
Senior GenAI Engineer/Data Scientist / Remote Molina Healthcare IncSenior GenAI Engineer/Data Scientist / RemoteNERemote6 plus years work experience as a data scientist preferably in healthcare environment but candidates with suitable experience in other industries will be considered •Knowledge of big data technologies (e.g., Hadoop, Spark) •Familiar with relational database concepts, and SDLC concepts •Demonstrate critical thinking and the ability to bring order to unstructured problems •Technical Proficiency: Strong programming skills in languages such as Python and R, and experience with machine learning frameworks like TensorFlow, Keras, or PyTorch. You will work at the intersection of LLMs, systems engineering, and applied ML, building intelligent agents that reason, plan, interact with tools, and operate reliably in real-world environments-particularly across regulated domains such as healthcare.
Health Plan Provider Relations Representative Molina Healthcare IncHealth Plan Provider Relations RepresentativeGreenville, SCPerforms an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.). Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
(RN) Remote Care Manager - SC based Molina Healthcare Inc(RN) Remote Care Manager - SC basedMyrtle Beach, SCRemoteCompletes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
Manager, Health Plan Marketing Communications, MCO (Remote, must reside in or near Illinois) Molina Healthcare IncManager, Health Plan Marketing Communications, MCO (Remote, must reside in or near Illinois)Chicago, ILRemoteResponsible for developing internal and external brand aligned communications and marketing campaigns, including marketing and communications materials for member and employee audiences, and ensuring all state/federal regulatory, accreditation, and internal requirements are met for health plan communications and materials. Tracks and trends member/provider education, trainings, and meetings for internal review and regulatory review - identifies any systemic issues for tracking, trending and process improvement.