Jobs at Molina Healthcare (Now Hiring) — 365 open — Page 2
Associate Program Manager, Process & Performance Monitoring, Managed Care (Remote in FL Preferred)
Long Beach, California, United States · Remote OK
$21/hr–$42/hr
Mid level$2.4B raised
Molina Healthcare is hiring several Associate Program Managers in our Government Contracts division. Associate program managers will be responsible for ensuring services, issue resolution, organization, communication, an…
Skills: Program Management, Process Monitoring, Cross-functional Collaboration, Excel, Data Analysis
Associate Analyst, Actuarial - REMOTE
Long Beach, California, United States · Remote OK
$41k–$89k/yr
Entry level$2.4B raised
JOB DESCRIPTION Job Summary Provides entry level support for Medicaid risk adjustment. Responsible for being subject matter expert for risk adjustment programs in multiple states. Maintain risk adjustment model, estimate…
Skills: Risk Adjustment, Actuarial Modeling, Data Analysis, Financial Impact Calculation, Predictive Analytics
Field Care Manager, LTSS (RN) - Local Travel Required
Long Beach, California, United States · On-site
Mid level$2.4B raised
JOB DESCRIPTION Opportunity for TX RN to join Molina as a Care Manager working with our Medicaid members in the southwest communities of Duncanville, Cedar Hill, and DeSoto in the Dallas, TX service delivery area. Respon…
Skills: Care Management, Case Management, Patient Assessment, Care Planning, LTSS
Manager, National Provider Services
Long Beach, California, United States · Remote OK
$66k–$143k/yr
Senior$2.4B raised
***Remote and must live in the United States*** JOB DESCRIPTION Job Summary Leads and manages team responsible for enterprise network management and operations activities including network development, network adequacy, …
Skills: Network Management, Provider Relations, Strategic Planning, Project Management, Contracting Strategy
Field Care Manager, LTSS (RN) - Local Travel Required
Long Beach, California, United States · On-site
$26/hr–$51/hr
Mid level$2.4B raised
JOB DESCRIPTION Opportunity for TX RN to join Molina as a Care Manager working with our Medicaid members in Benbrook, TX, southwest of Fort Worth. Responsibilities include completing in-home, face-to-face assessments wit…
Skills: Care Management, Case Management, Patient Assessment, Care Planning, Medication Reconciliation
Lead Analyst, Data & Analytics
Long Beach, California, United States · On-site
$66k–$143k/yr
Senior$2.4B raised
Job Description Job Summary Provides lead level analyst support as a technical leader responsible for designing, developing, and delivering advanced data and reporting solutions to support strategic decision-making. Anal…
Skills: SQL, Power BI, SSRS, Data Analysis, Technical Leadership
Correspondence Processor (2nd Shift: Tues-Sat / Sun-Thurs)
Long Beach, California, United States · On-site
$12/hr–$26/hr
Entry level$2.4B raised
JOB DESCRIPTION Job Summary Provides support for member correspondence activities. Responsible for generating clinical determination letters for members and providers, and following established guidelines and standards r…
Skills: Correspondence Processing, Clinical Determination Letters, Regulatory Compliance, Attention To Detail, Time Management
Care Manager, LTSS (RN) (Bilingual Spanish) - Field travel in Milwaukee County, WI)
Long Beach, California, United States · On-site
$26/hr–$51/hr
Mid level$2.4B raised
JOB DESCRIPTION Family Care with My Choice Wisconsin This opening is for a Bilingual Spanish speaking RN. Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific…
Skills: Care Management, Care Coordination, LTSS, Bilingual Spanish, Member Assessment
Field Care Manager, LTSS (RN) - Local Travel Required
Long Beach, California, United States · On-site
$26/hr–$51/hr
Mid level$2.4B raised
JOB DESCRIPTION Opportunity for TX RN to join Molina as a Care Manager working with our Medicaid members in Fort Worth in neighborhoods surrounding the zoo. Responsibilities include completing in-home, face-to-face asses…
Skills: Care Management, Case Management, Patient Assessment, Care Planning, LTSS
Associate Specialist, National Credentialing
Long Beach, California, United States · On-site
Entry level$2.4B raised
JOB DESCRIPTION Job Summary Provides entry level support for Molina enterprise credentialing activities. Ensures that the Molina provider network consists of providers that meet all regulatory and risk management criteri…
Skills: Credentialing, Data Entry, Internet Research, Microsoft Office, Verbal Communication
Correspondence Processor (1st Shift: Tues-Sat / Sun-Thurs)
Long Beach, California, United States · On-site
Entry level$2.4B raised
JOB DESCRIPTION Job Summary Provides support for member correspondence activities. Responsible for generating clinical determination letters for members and providers, and following established guidelines and standards r…
Skills: Correspondence Processing, Clinical Determination Letters, Regulatory Compliance, Attention To Detail, Time Management
Manager, Provider Configuration
Long Beach, California, United States · On-site
Senior$2.4B raised
JOB DESCRIPTION Job Summary Leads and manages team responsible for provider data management (PDM) activities including analyzing business processes related to PDM, identifying areas for improvement, and developing and im…
Skills: Provider Data Management, Business Analytics, Data Analysis, Leadership, Stakeholder Management
Medical Director (Medicare/Appeals)
Long Beach, California, United States · On-site
$186k–$363k/yr
Mid level$2.4B raised
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 Necessity Review, Utilization Management, Appeals Process Management, Clinical Quality Improvement, Regulatory Compliance
Analyst, Data & Analytics (PST hours)
Long Beach, California, United States · On-site
Mid level$2.4B raised
Job Description Job Summary Design and implement processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Ga…
Skills: Data Analysis, Data Mining, Data Validation, SQL, Databricks
Representative, Support Center III
Long Beach, California, United States · On-site
Mid level$2.4B raised
JOB DESCRIPTION Job Summary Provides level III support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating…
Skills: Customer Service, Call Center Operations, Healthcare Insurance Knowledge, Conflict Resolution, Data Processing
Care Manager (RN)- Medicare Stars
Long Beach, California, United States · On-site
$23/hr–$51/hr
Mid level$2.4B raised
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
AVP, National Member Quality Interventions
Long Beach, California, United States · On-site
$141k–$275k/yr
Senior+$2.4B raised
JOB DESCRIPTION Job Summary Provides strategy and leadership to team responsible for enterprise-wide member quality interventions. Responsible for building, delivering, and implementing Molina member facing programs. Ove…
Skills: Quality Improvement, Risk Adjustment, HEDIS Compliance, NCQA Standards, CAHPS Improvement
AVP, National Quality Improvement (Remote)
Long Beach, California, United States · Remote OK
$122k–$239k/yr
Senior+$2.4B raised
JOB DESCRIPTION Job Summary Provides strategy and leadership to team responsible for enterprise quality improvement (QI) activities. Responsible for overseeing, planning, and implementing new and existing health care qua…
Skills: Quality Improvement, HEDIS Compliance, NCQA Accreditation, Star Ratings, CAHPS Improvement
Program Manager (Clinical COE)
Long Beach, California, United States · On-site
Mid level$2.4B raised
JOB DESCRIPTION Job Summary Provides support to Molina functional areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governa…
Skills: Program Management, Project Management, Operational Process Improvement, Managed Care, Microsoft Project
Care Review Clinician (RN) Remote (Must Reside In AZ)
Long Beach, California, United States · Remote OK
Mid level$2.4B raised
JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insura…
Skills: Clinical Review, Medical Necessity Verification, Utilization Management, Prior Authorization, Clinical Guidelines Analysis
