Long Beach, California, United States · Remote OK
Job Summary This role will act as an advocate for Molina members and a subject matter expert about members’ extra benefits and covered services. The overarching driver will be increasing member retention and member satis…
Skills: Critical Thinking, Problem Solving, Data Tracking, Reporting, Customer Service
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for health plan provider network complex contracting activities. Supports network strategy and development with respect to adequacy, financial …
Skills: Provider Network Contracting, Contract Negotiation, Value-Based Payment Methodology, Managed Health Care, Financial Analysis
Long Beach, California, United States · Hybrid
$19/hr–$46/hr
JOB DESCRIPTION Job Summary Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between t…
Skills: Provider Relations, Network Management, Customer Service, Healthcare Delivery System, Microsoft Office
Long Beach, California, United States · Hybrid
JOB DESCRIPTION **This is a hybrid role. Since your team is based in Thurston/Mason County, you will also need to be located there.** Job Summary Provides support for care transition activities. Facilitates transitional …
Skills: Care Transition, Hospital Discharge Planning, Behavioral Health, Care Coordination, Motivational Interviewing
Long Beach, California, United States · On-site
$83k–$135k/yr
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as pr…
Skills: Provider Relations, Network Management, Network Adequacy, Value-Based Payment, Alternative Payment Methods
Long Beach, California, United States · On-site
$54k–$118k/yr
JOB DESCRIPTION Job Summary Provides senior level analyst support for configuration information management activities. Responsible for accurate and timely implementation and maintenance of critical information on claims …
Skills: Configuration Information Management, Claims Processing Systems, Data Analysis, Microsoft Excel, VLOOKUP
Long Beach, California, United States · Remote OK
Job Description Job Summary Leads solution design architectures for several applications – mapping business requirements to high level design covering technologies, services, and products. Design, describe, and manage th…
Skills: Genesys Cloud, Solution Architecture, API Integration, Voice AI, Healthcare Domain
Long Beach, California, United States · On-site
$26/hr–$51/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of …
Skills: Care Management, Care Coordination, Member Assessment, Care Planning, Waiver Enrollment
Long Beach, California, United States · Hybrid
$26/hr–$51/hr
Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/lif…
Skills: Personal Care Assessment, Case Management, Patient Education, Care Planning, Clinical Documentation
Long Beach, California, United States · Hybrid
$19/hr–$38/hr
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 · Remote OK
$96k–$209k/yr
JOB DESCRIPTION Job Summary Leads and directs a team responsible for financial analysis activities across designated business areas - focusing on operational performance and strategic partnerships. Facilitates analysis, …
Skills: Financial Analysis, Strategic Planning, Budgeting, Forecasting, Data Modeling
Long Beach, California, United States · On-site
JOB DESCRIPTION The schedule is flexible and does not follow a standard 8:00 AM–5:00 PM EST workday. You must have behavioral health experience. Instead, there is a minimum requirement of 2 hours of after-hours work per …
Skills: Care Management, Care Coordination, Clinical Assessment, Case Management, Motivational Interviewing
Long Beach, California, United States · On-site
$29/hr–$56/hr
Job Description Job Summary Provides support for clinical training activities. Creates and delivers clinical training programs for clinical staff across the enterprise to orient employees to Molina clinical methodologies…
Skills: Clinical Training, Curriculum Development, Utilization Management, Care Management, Instructional Design
Long Beach, California, United States · On-site
$29/hr–$56/hr
JOB DESCRIPTION Job Summary Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and…
Skills: Clinical Auditing, Utilization Management, Care Management, Regulatory Compliance, Analytical Skills
Long Beach, California, United States · On-site
$29/hr–$56/hr
JOB DESCRIPTION Job Summary Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and…
Skills: Clinical Auditing, Utilization Management, Care Management, Regulatory Compliance, Analytical Skills
Long Beach, California, United States · Remote OK
$88k–$190k/yr
Job Summary: Molina Healthcare is seeking a Manager, Applications to lead a high-impact team responsible for ETL development, reporting support, and technical enablement across key TCIM workstreams. This is a people lead…
Skills: ETL Development, Azure Data Factory, People Leadership, SQL, AI Adoption
Long Beach, California, United States · On-site
$26/hr–$51/hr
JOB DESCRIPTION We are seeking a Texas licensed LPC or LCSW to join our behavioral health care management team as a Transition of Care Coach, supporting our Medicaid members with a behavioral health diagnosis and have be…
Skills: Discharge Planning, Case Management, Behavioral Health Care, Motivational Interviewing, Care Coordination
Long Beach, California, United States · On-site
$26/hr–$51/hr
JOB DESCRIPTION Job Summary Provides support for member clinical review processes specific to applied behavioral analysis (ABA) services. Responsible for verifying that behavioral health services are medically necessary …
Skills: Clinical Review, Applied Behavioral Analysis, Medical Necessity Verification, Utilization Management, Care Management
Long Beach, California, United States · Remote OK
Job Description The Medicare Strategy & Operations Manager role supports senior leaders in creating segment and state-specific strategies, as well as driving key strategic and operational initiatives to transform the org…
Skills: Data Analysis, Market Research, Strategic Planning, Regulatory Analysis, Project Management
Long Beach, California, United States · Remote OK
$80k–$172k/yr
Job Summary Leads and directs team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Assuran…
Skills: Delegation Oversight, Vendor Management, Auditing, Compliance, Project Management
Long Beach, California, United States • Remote OK
Sign up with Clera and we'll reach out the moment a role actually fits you — no more spraying applications into the void.
Acts as a subject matter expert and advocate for Molina members regarding extra benefits and covered services to increase retention and satisfaction. Oversees the tracking and reporting of value-added benefits for Medicaid and MyCare Ohio while collaborating with internal and external stakeholders.
Requires a high school diploma and at least 2 years of experience in customer service, advocacy, project management, or core operations. Must possess a valid driver's license and proficiency in Microsoft Suite and Smartsheet.
Job Summary
This role will act as an advocate for Molina members and a subject matter expert about members’ extra benefits and covered services. The overarching driver will be increasing member retention and member satisfaction, and facilitating improvements in the health plan. Uses data sources like member utilization, satisfaction, and operational inputs to drive improvement in the member experience.
Represents member perspective in areas involving member impact and engagement. Oversees, tracks, and reports on value-added benefits for Medicaid and MyCare Ohio. Partners with state and enterprise vendor teams to ensure benefit integrity.
Required Education
High School diploma.
Required Experience
2 years experience in either customer service, consumer advocacy, project management, or core operations. Experience tracking and reporting on data in Excel and Smartsheet. Basic understanding of managed care. Proficiency with Microsoft Suite programs (i.e. Word, Excel, PowerPoint, Outlook, OneNote, Teams). Proofreading ability.
Required License, Certification, Association
Must have valid driver's license with good driving record and be able to drive within the state of Ohio with reliable transportation.
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
