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...
Job SummaryResponsible for ensuring Molina compliance with both regulatory and company Information Security policies. Monitors compliance and maintains an awareness of state, federal, and company established Information Security regulations/policies by working with internal Molina staff and vendors to identify and resolve areas of non-compliance. Creates an appropriate level of awareness for these...
Job Summary Responsible for general building maintenance and equipment repair for Corporate and California sites, mail and supply delivery to and from Corporate & SMO's, SMO equipment maintenance & repair. Essential Functions • Responsible for routine repair & maintenance of equipment & company facilities. • Completes work orders as requested. • Packing supplies for delivery to SMO • Respons...
Job Summary Responsible for working with business stakeholders, including project management and Technical leads, to translate business requirements into a technical design strategy for implementing the application or solution. Coordinates with Technical leads and developers to implement the application or solution, and shows how the current and future needs of business stakeholders will be met i...
Job SummaryDevelop and maintains data models to develop the call propensity of members based on demographic / location / product features. Will be responsible to analyze data from multiple sources including ACD, CRM, ticket / Case management system and external demographic data. Should have strong statistical capabilities and have the ability to create new correlations parameters and evaluate impa...
Job Summary Point of contact for submission/resolution of Provider Disputes and/or Member Appeals Resolutions. Assesses and completes appropriate documentation for tracking/trending data. Conducts all pertinent research in order to evaluate, respond and close incoming Provider Disputes and/or Member Appeals accurately, timely and in accordance with all established regulatory guidelines inclusive ...
Claims Representative (Provider Inquiry R & R) - Molina Healthcare Job Summary Resolves Provider Reconsideration Requests (PRR) from providers relating to claims payment and requests for claim adjustments. Researches claims processing guidelines, provider contracts, fee schedules and system configurations to determine root cause of payment error. Identifies potential Provider problems through a ...
Data Management Analyst II (SQL Exp) - Long Beach, CA Job Summary Prepares various encounter data reports to support plan's encounter data operations and ongoing performance management activities. Extracts data from various systems, provides related analyses to identify trends and monitor provider encounter data submission performance, and provides reports to assist in plan's encounter data deci...
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...
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...
Job Summary Primarily responsible to lead the design, development, testing and implementation of custom software applications and off the shelf technologies. Essential Functions • Develops software (hands on code development) to meet key business objectives. • Designs and develops applications using .Net Framework, BizTalk C#, VB.NET, ASP.NET, Java Script, XML, HTML, DHTML, Microsoft SQL Serve...
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...

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