Long Beach, California, United States · On-site
Job Description Job Summary Designs and implements reports and analyses to help the business team make informed decisions and meet regulatory requirements. Offers insight into key business problems and deliverables by ap…
Skills: SQL, Azure Databricks, Python, Excel, Statistical Analysis
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for both members and pr…
Skills: Medical Oversight, Utilization Management, Medical Necessity Review, Clinical Quality Improvement, Regulatory Compliance
Long Beach, California, United States · Remote OK
$49k–$107k/yr
JOB DESCRIPTION Provides support for compliance auditing activities. Responsible for evaluating Molina's adherence to regulatory requirements, internal policies, and health care industry standards by identifying complian…
Skills: Compliance Auditing, Regulatory Analysis, Risk Assessment, Internal Controls, Problem Solving
Long Beach, California, United States · Remote OK
$60k–$130k/yr
Job Summary: Provides senior level support for Molina Physical Security enterprise applications. Responsible for executing and managing the applications that support physical security operations, emergency response, and …
Skills: Physical Security Operations, Business Continuity Management, Crisis Management, Emergency Response, System Analysis
Long Beach, California, United States · Remote OK
$96k–$209k/yr
***Remote and must live in the United States*** Job Description Job Summary Provides associate level support for legal counsel activities. Provides legal advisement related to rights, obligations, and privileges of the o…
Skills: Corporate Governance, Entity Management, Legal Drafting, Regulatory Audits, Cross-functional Collaboration
Long Beach, California, United States · Remote OK
$18/hr–$35/hr
JOB DESCRIPTION Job Summary *Must go to field as needed* Provides entry level support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Ser…
Skills: Customer Service, Provider Relations, Claims Processing, Network Management, Microsoft Office
Long Beach, California, United States · On-site
$52k–$102k/yr
JOB DESCRIPTION Job Summary Provides senior level support for government regulatory contracts activities. Responsible for the development and administration of contracts with state and/or federal governments for Medicaid…
Skills: Government Contracting, Regulatory Compliance, Medicaid, Medicare, Marketplace Programs
Long Beach, California, United States · Remote OK
Molina Healthcare is hiring for a CSR for our Medication Therapy Management department. This role will be working Monday through Friday 10am to 630pm Mountain Standard Time. Highly qualified candidates will have exceptio…
Skills: Customer Service, Windows Software Navigation, Typing, Multitasking, HIPAA Compliance
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Leads and supervises team responsible for configuration Oversight activities including accurate and timely implementation and maintenance of critical information on claims databases, validatio…
Skills: Payment Integrity, Claims Audit, Oversight, Supervision, Healthcare Auditing
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides support for Molina Medicare sales activities. Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid …
Skills: Medicare Sales, Account Management, Sales
Long Beach, California, United States · On-site
JOB DESCRIPTION Job SummaryProvides support for community-based member advocacy activities. Serves as a local member advocate and resource, using knowledge of the community and resources available to engage and assist vu…
Skills: Member Advocacy, Case Management, Community Outreach, Customer Service, Time Management
Long Beach, California, United States · Remote OK
$13/hr–$26/hr
JOB DESCRIPTION Job Summary Provides support for member enrollment activities including preparation, processing and maintenance of new members and reenrollment. Processes and maintains health plan member and enrollment r…
Skills: Member Enrollment, Customer Service, Data Processing, HIPAA Compliance, Microsoft Office
Long Beach, California, United States · Hybrid
$27/hr–$54/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to …
Skills: Care Management, Care Coordination, Comprehensive Assessments, Motivational Interviewing, Medication Reconciliation
Long Beach, California, United States · Remote OK
JOB DESCRIPTION Job Summary Provides senior level analyst support for Molina enterprise risk and quality reporting activities. Designs and develops reporting solutions to support Healthcare Effectiveness Data and Informa…
Skills: T-SQL, Power BI, SSIS, SSRS, HEDIS
Long Beach, California, United States · Hybrid
$25/hr–$49/hr
JOB DESCRIPTION Job Summary Provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from hospital admission to all other settings. Strives to ensure …
Skills: Care Transition Coordination, Hospital Discharge Planning, Patient Education, Motivational Interviewing, Case Management
Long Beach, California, United States · On-site
Job Summary Provides non-clinical administrative support to the care management function, and contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum. Contri…
Skills: Administrative Support, Case Assignment, Member Screening, Scheduling, Data Entry
Long Beach, California, United States · Remote OK
$23/hr–$51/hr
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insur…
Skills: Utilization Review, Clinical Assessment, Prior Authorization, Medical Necessity Verification, Case Management
Long Beach, California, United States · On-site
$24/hr–$46/hr
Come join us for our upcoming virtual hiring event! Event Date & Time: Tuesday July 14th at 12:00pm EST Register here today: Florida Care Managers (Miami) & Care Review Clinicians Virtual Hiring Event Event Date & Time: …
Skills: Care Management, Care Coordination, Patient Assessment, Care Planning, Motivational Interviewing
Long Beach, California, United States · On-site
$26/hr–$51/hr
Come join us for our upcoming virtual hiring event! Event Date & Time: Tuesday July 14th at 12:00pm EST Register here today: Florida Care Managers (Miami) & Care Review Clinicians Virtual Hiring Event Event Date & Time: …
Skills: Behavioral Health Assessment, Care Coordination, Case Management, Motivational Interviewing, Care Planning
Long Beach, California, United States · Remote OK
$50k–$97k/yr
JOB DESCRIPTION Job Summary Provides analyst support for health plan risk and quality reporting activities. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks ou…
Skills: SQL, Power BI, Data Analysis, HEDIS, Risk Adjustment
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Designs and implements reports and dashboards to provide actionable insights and meet regulatory requirements for the pharmacy department. Collaborates across departments to analyze structured and unstructured data and improve business performance.
Requires an Associate's degree and 1-3 years of healthcare experience with proficiency in SQL, Azure Databricks, Python, and Excel. A Bachelor's degree and 3-5 years of experience with specific pharmacy data knowledge are preferred.
Job Summary
Designs and implements reports and analyses to help the business team make informed decisions and meet regulatory requirements. Offers insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies.
KNOWLEDGE/SKILLS/ABILITIES
JOB QUALIFICATIONS
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
Offices: 200 Oceangate, Long Beach, California 90802, US
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
Offices: 200 Oceangate, Long Beach, California 90802, US
