JOB DESCRIPTION Job Summary Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations
JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members
Job Summary Responsible for internal business projects and programs associated with Behavioral Health Operations involving department or cross-functional teams of subject matter experts. Monitors the project from inception through delivery. May engage and oversee the work
JOB DESCRIPTION Job Summary Manages a team of professional Configuration Analysts. Responsible for operational activities for the assigned team, including accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be
JOB DESCRIPTION Opportunity for TX licensed RN to join Molina as a Case Manager working with our Medicaid members in the service delivery area covering Conroe, East Houston, and The Woodlands, TX. Part of the responsibilities of
JOB DESCRIPTION Job Summary Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provisions of medical staff services.
JOB DESCRIPTION Job Summary Molinas Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting
JOB DESCRIPTION Job Summary Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability, and retention goals, while following ethical
JOB DESCRIPTION Job Summary The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the environment that patients feel most
JOB DESCRIPTION Job Summary The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, community, and nursing facility settings. Provides needed care in the environment that patients feel most
JOB DESCRIPTION Job Summary Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules
Job Description Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for
JOB DESCRIPTION Opportunity for TX licensed LVN or an experienced Case Manager to join Molina as a Case Manager working with our Medicaid members in the service delivery area of Fort Worth, TX. Part of the responsibilities
JOB DESCRIPTION For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of MI. Case Manager RN will work in remote setting
JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for
*Remote and must live in the United States * JOB DESCRIPTION Job Summary Molina Health Plan Dental Provider Network Management and Operations jobs are responsible for dental network development, network adequacy and provider training and education, in
Job Description Job Summary Focuses on large scale process improvement, organizational change management, project management and other processes relative to the business and enterprise. Project/delivery management includes estimation of work effort, costing, planning, and issue/risk management.
JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members
JOB DESCRIPTION We are seeking licensed social worker, who must live in the Dayton OH area, and must be licensed for the state of OHIO. The Case Manager will support MMP Waiver Program. Excellent computer skills
Job Description JOB DESCRIPTION Job Summary The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and accurate reports. As the senior level team member, this role leads efforts to
