JOB DESCRIPTIONJob SummaryResponsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and sim...
JOB DESCRIPTIONJob SummaryJob SummaryProvides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.KNOWLEDGE/SKILLS/ABILITIES P...
Job Description Job Summary Responsible for collecting, storing, processing, and analyzing large sets of data. The primary focus will be on choosing optimal solutions to use for these purposes, then......
JOB DESCRIPTIONJob SummaryResponsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and sim...
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Job Duties Responsible for all Member and Provider Services, including Workforce Management, Reporting, Data & Analytics, Quality Assurance, Business Solutions, Vendor Performance and Telephony across Medicaid, Medica...
JOB DESCRIPTIONJob SummaryMolina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the compan...
Job DescriptionJob Description****This job position will work EST business hours******Job SummaryThe Analyst, Encounters is responsible for monitoring inbound and outbound encounters processes and ensuring timely, accurat...
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Job SummaryThis Program Director is responsible for managing the Marketplace provider contracting process for Molina Healthcare in the Western regions (ie. CA, WA, NV, AZ). The Marketplace Program Director leads......
JOB DESCRIPTIONJob SummaryResponsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintains the risk adjustment model, identifies risks, and estimates risk scores an...
Job DescriptionJob SummaryThe Lead Auditor, Delegation Oversight is responsible for leading and managing the auditing of complex and multi-delegated high-risk vendors. Brings all best practices together to management for ...
For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN......
JOB DESCRIPTIONJob SummaryThe Care Connections Representative primary focus is to conduct outbound calls to Molina members and schedule appointments with our Nurse Practitioners. As part of Molina's benefit package, the.....
JOB DESCRIPTIONJob SummaryProvider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence...
JOB DESCRIPTIONJob SummaryResponsible for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with the standards and re...
JOB DESCRIPTIONJOB SUMMARY (Purpose of the Job & high-level summary):Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise-wide. It is a centralized corporate funct...
JOB DESCRIPTIONJob SummaryResponsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and sim...
JOB DESCRIPTIONJob SummaryField Travel in Webster, Kossuth, Humboldt and Cerro Gordo CountiesMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan an...
We are seeking a LVN CASE MANAGER (CALIFORNIA LICENSED VOCATIONAL NURSE) for this role. Must have current licensure for the state of California. California is not a compact state at......
JOB DESCRIPTIONJob SummaryMolina 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, i...
JOB DESCRIPTIONJob SummaryThis role is on the Corporate Financial Planning and Analysis team primarily supporting G&A submissions. The successful candidate in this position will assist in the management of G&A......
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