Long Beach, California, United States · On-site
$88k–$198k/yr
JOB DESCRIPTION Job Summary Provides 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 nurs…
Skills: Primary Care, Patient Evaluation, Care Coordination, Chronic Disease Management, Medical Diagnosis
Long Beach, California, United States · On-site
$66k–$130k/yr
JOB DESCRIPTION Job Summary Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls,…
Skills: Program Management, Project Management, Operational Process Improvement, Managed Care, Microsoft Project
Long Beach, California, United States · On-site
$19/hr–$38/hr
JOB DESCRIPTION Job Summary Position collaborates daily with LTSS providers to include Adult Family Homes, Assisted Livings, Adult Day Care Centers, Ancillary Providers, and Nursing Homes in review of potential concerns …
Skills: Provider Relations, Quality Management, Contract Compliance, Regulatory Oversight, Customer Service
Long Beach, California, United States · Hybrid
JOB DESCRIPTION Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG …
Skills: Care Coordination, Case Management, Community Resource Research, Budget Management, HIPAA Compliance
Long Beach, California, United States · Hybrid
JOB DESCRIPTION Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG …
Skills: Care Coordination, Case Management, Budget Management, Community Resource Research, HIPAA Compliance
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides support for Molina benefits telesales activities. Facilitates outgoing calls and takes incoming calls from prospective members to provide education on Molina product benefits, and con…
Skills: Telesales, Medicare, Medicaid, Marketplace, Life & Health Insurance License
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides executive strategy and leadership to team responsible for network operations and contracting activities. Supports network strategy and development with respect to adequacy, financial …
Skills: Network Management, Contract Negotiation, Healthcare Operations, Value-Based Payment, Reimbursement Strategy
Long Beach, California, United States · On-site
Job Description Job Summary Performs behavioral health utilization reviews, applying evidence-based criteria, and collaborating with physicians to ensure clinically appropriate, cost-effective, and regulatory-compliant c…
Skills: Behavioral Health Utilization Review, Medical Necessity Evaluation, Clinical Decision-Making, Regulatory Compliance, Case Review
Long Beach, California, United States · On-site
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, insurance policies, a…
Skills: Clinical Review, Medical Necessity Verification, Utilization Management, Prior Authorization, Clinical Guidelines Analysis
Long Beach, California, United States · On-site
$26/hr–$51/hr
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina to work with our IDD members in the Houston service delivery area. Our Care Managers conduct face-to-face meetings with the members in their homes, compl…
Skills: Care Management, Member Assessment, Care Planning, Case Coordination, Motivational Interviewing
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides executive level strategy and leadership to the health plan in the development and execution of care management and utilization management programs. Develops clinical practice guidelin…
Skills: Executive Strategy, Care Management, Utilization Management, Clinical Practice Guidelines, Medical Necessity Oversight
Long Beach, California, United States · On-site
$102k–$198k/yr
JOB DESCRIPTION Job Summary Provides 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 nurs…
Skills: Primary Care, Care Coordination, Physical Examinations, Chronic Disease Management, Diagnostic Testing
Long Beach, California, United States · On-site
$21/hr–$48/hr
Job Description Job Summary The Specialist, Patient Care Delivery is a multi-disciplinary healthcare professional who delivers high-quality, compassionate care to health plan members in their homes. This role combines cl…
Skills: Clinical Care, Phlebotomy, Patient Education, Vital Signs Collection, Electronic Health Records
Long Beach, California, United States · Remote OK
Job Description Job Summary Reporting to the Chief Digital Officer, the AVP Enterprise Architecture is responsible for designing and communicating the shared architectural vision and standards for the Information Technol…
Skills: Enterprise Architecture, Azure Cloud, AI/ML, Software Engineering, Healthcare Domain Expertise
Long Beach, California, United States · On-site
Knowledge/Skills/Abilities Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes,…
Skills: Healthcare Claims Analysis, Pharmacy Data Analysis, Lab Data Analysis, Network Utilization, Cost Containment
Long Beach, California, United States · On-site
Come join us for our upcoming virtual hiring event! Event Date & Time: Tuesday, July 14th at 12:00pm EST Florida Care Managers & Care Review Clinicians Virtual Hiring Event Event Date & Time: Thursday, July 23rd at 12:00…
Skills: Care Management, Care Coordination, Case Management, Motivational Interviewing, Clinical Assessment
Long Beach, California, United States · On-site
$102k–$198k/yr
JOB DESCRIPTION Job Summary Provides 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 nurs…
Skills: Primary Care, Patient Evaluation, Care Coordination, Chronic Disease Management, Diagnostic Testing
Long Beach, California, United States · On-site
$102k–$198k/yr
JOB DESCRIPTION Job Summary Provides 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 nurs…
Skills: Primary Care, Patient Evaluation, Care Coordination, Chronic Disease Management, Diagnostic Testing
Long Beach, California, United States · On-site
$88k–$198k/yr
JOB DESCRIPTION Job Summary Provides 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 nurs…
Skills: Primary Care, Patient Evaluation, Care Coordination, Chronic Disease Management, Diagnostic Testing
Long Beach, California, United States · Hybrid
JOB DESCRIPTION Job Summary Will require to be infield twice a week subject to change Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training a…
Skills: Provider Relations, Network Management, Customer Service, Healthcare Delivery System, Microsoft Office
Long Beach, California, United States • On-site
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Provides screening, preventive primary care, and medical services to members in non-clinical settings such as homes and community facilities. Coordinates care plans, performs physical exams, and manages both acute and chronic health complaints to improve member outcomes.
Requires at least 1 year of experience as a Nurse Practitioner with an active FNP license, DEA license, and BLS certification. Must hold national certification from AANP or ANCC and possess a valid driver's license for extensive regional travel.
Provides 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. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
• Provides general medical care and care coordination to various and/or specific patient member populations – adult, women’s health, pediatric, and geriatric.
• Performs comprehensive evaluations including history and physical exams for gaps in care and preventive assessments.
• Addresses both chronic and acute primary care complaints, and demonstrates ability to ascertain medical urgency.
• Establishes and documents reasonable medical diagnoses.
• Seeks specialty consultation as appropriate.
• 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.
• Understands when a member's needs are beyond their scope of knowledge and when physician oversight is needed.
• Creates and implements a medical plan of care.
• Schedules appointments for visits when appropriate.
• Provides post-discharge coordination to reduce hospital readmission rates and emergency room utilization.
• Performs face-to-face in-person visits in a variety of settings including in-home, skilled nursing facilities, and public locations.
• Performs face-to-face visits via alternative modalities based on business need, leadership direction and state regulations.
• Orders bulk laboratory orders to target specific member populations.
• Performs alternating on-call coverage to triage any urgent lab results and pharmacy inquiries and develops appropriate plans of care.
• Participates in community-based “pop up clinics” to build relationships with communities, and address gaps in health care.
• Drives up to 120 miles a day on a regular basis to a variety of locations within the assigned region. Drives beyond 120 miles as part of extended mileage may be required on special project days. Special projects may include an overnight hotel stay.
• Obtains and maintains cross-state license in other states besides home state based on business need.
• Collaborates with fellow nurse practitioners to develop best practices to perform work duties efficiently and effectively.
• Actively participates in regional meetings.
• May prescribe medications and perform procedures as appropriate.
• Performs timely medical records documentation in electronic medical record (EMR) computer system.
• On occasion, may be required to walk flights of stairs while carrying up to 50 lbs. of equipment.
• Engages in practices constituting the practice of medicine in collaboration with and under the medical direction and supervision of a licensed physician to the degree required by state laws.
• Local travel required (based upon state/contractual requirements).
• At least 1 year of experience as a nurse practitioner, or equivalent combination of relevant education and experience.
• Active and unrestricted national certification from one of the following organizations: American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC).
• Current state-issued license to practice as a Family Nurse Practitioner (FNP). License must be active and unrestricted in state of practice.
• Prescriber Drug Enforcement Agency (DEA) license with authority to prescribe per state qualifications. License must be active and unrestricted in state of practice.
• Current Basic Life Support (BLS) certification.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently with minimal supervision and demonstrate self-motivation.
• Responsive in all forms of communication.
• Ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills; ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency, and electronic medical record (EMR) experience.
• Experience as a registered nurse or nurse practitioner in a home health, community health or public health setting.
• Experience in home health as a licensed clinician, especially in management of chronic conditions.
• Experience with underserved populations facing socioeconomic barriers to health care.
• Immunization and point of care testing skills.
• Bilingual.
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
