Molina Healthcare Jobs in Long Beach - Page 4

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Job Summary The Director of HEDIS is a key quality leader within the organization. This person is empowered to advise senior management and other departments on HEDIS calculation and reporting and how it relates to initiatives like STAR ratings, NCQA Accreditation, State P4P initiatives, other State performance requirements, clinical interventions and procurement. Essential Functions • Works with...
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 and...
Job Summary The Corporate Recruiter is responsible for providing excellent staffing services to Molina leaders and associates. Delivers high quality professional level candidates and advances the Molina brand across numerous markets and professional communities, while guiding hiring managers and candidates through the Molina selection process. Perform full lifecycle recruiting and maintain excelle...
Job Summary Resolves issues and problems encountered in day-to-day claims processing, auditing and recovery. Is recognized by management and staff as an expert in issues related to claims processing, payment dispute resolution, cost containment, audit processes, recovery functions and contract interpretation. Plays a key role in training, problem resolution, work floor optimization and process imp...
Job Summary Create and maintain reports supporting all functional areas of claims production, adjustments, recoveries, auditing, compliance and KPI. Ability to work closely with all levels of management to determine business requirements. Proactively perform analysis of data and provide management with concise summary and recommendations if appropriate. Familiar with software life cycle and workin...
Job Summary Claims Processing and adjudication of more complex CMS 1500 claims as well as processing of UB claims for specific services. Assists with claims research when necessary. Must meet and/or exceed qualitative production standards. Essential Functions • Quality Standard - Meet and Maintain the quality rate. • Claims Adjudication - Meet and consistently maintain production standards. • Team...
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