Molina Healthcare Jobs in Long Beach - Page 4

Currently, there are no Molina Healthcare jobs available in Long Beach, California. You may wish to explore jobs in nearby locations on the Molina Healthcare jobs in California page or view related jobs below.
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Job Summary Operates in the capacity of a subject matter expert on topics including but not limited to encounter transactions/submission, recovery or claims editing requirements and regulations specific to states in which Molina operates. Researches, verifies and interprets state requirements relating to all aspects of the encounter, recovery and cost savings functions. Develops or modifies inter...
Healthcare Services Clinical Trainer/RN Job Summary Reviews healthcare service delivery and provides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with all state and federal regulations and guidelines. Collaborates with the integrated Healthcare Services team to assess quality and implement clinical training programs to facilitate s...
RN Case Manager III - Molina Helathcare Job Summary Responsible for health care management and coordination of Molina Healthcare members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative plan of care. Coordinates and monitors Molina member's progress and services to ensure consistent cost effective...
Care Review Clinician III- RN Hospital Based Job Summary Works with the Utilization Management team responsible for prior authorizations, inpatient and outpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members tha...
.Job Summary Responsible for the overall development, support and maintenance of the service performance management process. Creates and maintains a catalog of existing services offered by IT. Coordinates all service measurement, sharing information with IT process owners and service providers to evaluate future continuous improvement efforts. Essential Functions • Analyzes, reviews and measure...
Job Summary The Nurse Practitioner may be required to work a variety of settings (non-clinical or clinical settings) and provide medical care to all levels of patients. Some programs/clinics may focus on specific populations (e.g., adult, geriatric, pediatric) The Nurse Practitioner will work in collaboration with his/her supervising physicians. He/she will perform comprehensive medical assessme...
Behavioral Health Social Worker - LCSW Job Summary Responsible for the assessment and coordination of the psychosocial needs of the patient and family; Coordinates and provides short-term counseling and goal focused interventions with patients and families that are age and developmentally appropriate. Acts as Liaison with the County mental health system in procuring mental health services for Mo...
Ultrasonographer (Per Diem) at College Medical Center Job SummaryPerforms diagnostics ultrasound procedures as requested by licensed physicians. Essential Functions Demonstrates ability to perform high quality ultrasound studies. • Assesses requisition for pertinent clinical indication related to requested imaging procedure. • Assesses patient's ability and potential intolerance to undergo the...
Job SummaryUnder limited guidance, the Compensation Analyst will work on compensation analyses, with guidance from the manager and other senior Compensation staff. In addition, the position is responsible for effective implementation, administration and maintenance of compensation programs and processes as it aligns with the Compensation/Total Rewards strategy. Responsibilities encompass job evalu...
Job Summary Supervises, oversees, implements, and evaluates all local QI and HEDIS interventions. Essential Functions • Implements goals and directives of HP QI Director and Manager for HEDIS and Interventions • Effectively manages internal and external vendor communications by collaborating and disseminating reports and defining program descriptions, and by sharing analytical findings. • Wor...
Job Summary Directly supervises daily activities/tasks performed by non-exempt and/or exempt employees. Monitors operations of Claims Department unit and actively assists, or provides direction to, subordinates as required using standard policies, procedures and guidelines. Essential Functions • Identify, interview and select candidates for employment. • Track and report individual performance...
Supervisor Case Manager - Molina Healthcare Job Summary Responsible for overseeing the Integrated Case Management staff focused on assisting Molina Healthcare members with their health care needs to achieve optimal clinical, financial and quality of life outcomes. Monitors information daily as appropriate including member metrics and staff productivity. Evaluates the services provided and outcom...
Job Summary This position is responsible for accurately entering provider demographic and contract affiliation information into the health plan system. Must be able to accurately interpret request and enter into the system in such a way that all data is correct and claims adjudication is optimized. Essential Functions • Receive information from outside party(ies) for update of information in co...
Medical Librarian/ For College Medical Center Job SummaryResponsible for day -to-day operation of the medical library. Provides input into the development of medical library policies and procedures. Maintains current knowledge of on-line database and search languages. Analyzes, formulates and performs on-line searches. Provides clinical librarian services, including participation in monitoring Co...
Systems AnalystLong Beach, CA Work with Cerner EMR with in a Hospital environment Requirements: Must have Cerner EMR experience Frontend EMR experience: configuration of forms, documentation and workflow Cerner programing experience is a plus Assists in the project definition, execution and implementation. Provides application, business process or functional domain leadership/expertise and p...
Reporting Analyst IILong Beach, CA Key skills - knowledge of member enrollment data, SQL, Access, Excel, Query writing, report extract and creation. Job SummarySupports our Medicaid client's reporting, data extraction and research requirements in a timely and professional manner. Researches, analyzes, and resolves system issues using business intelligence and decision support solutions. Manages ...
Job Summary Responsible for health care management and coordination of Molina Healthcare members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative plan of care. Coordinates and monitors Molina member's progress and services to ensure consistent cost effective care that complies with Molina policy an...
Job Summary Serves as a subject matter expert in the effective and efficient implementation and administration of Medicare benefits. Responsible for analyzing compliance and business requirements in order to ensure the successful implementation of Medicare mandatory and supplemental Part C benefits and Part D pharmacy benefits. Essential Functions This position exercises independent judgment on...
Manager, Reporting and Analytics - Claims Long Beach, CA Healthcare, Insurance, provider services, member services, reports, analystic, analyst, projects Accountable for the daily operation of one or more Claims teams. Responsible for assuring the achievement and maintenance of departmental key performance indicators as well federal and state specific requirements. Essential Functions• Manages...
Healthcare Transitions Coach I/RN or LVN Job SummaryResponsible for safely and effectively transitioning Molina members from acute or inpatient care to lower levels of care and/or home in a cost efficient manner. Provides assessment, planning, implementation, coordination, monitoring, and evaluation of services for Molina members as they transition care and follows them for 30 days post discharge...

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