Molina Healthcare Jobs & Careers

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54 Molina Healthcare jobs found on Monster.

Jobs 1 to 20 of 54
Molina Healthcare Bothell, WA, 98021
Job Summary Responsible for assisting in the implementation of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud, Waste and Abuse Plan across the Molina enterprise to ensure compliance with contractual and regulatory requirements. Develops and implements compliance policies and procedures, compliance training and programs for the Molina Enterprise. Investigates and resolves comp...
Molina Healthcare Charleston, SC
Job Summary: Responsible for implementing and monitoring local QI and HEDIS interventions. Essential Functions The position's essential functions are as follows: • Coordinates the preparation of annual HEDIS medical records project. • Coordinates medical record collection process with third party vendor and/or MHI. • Validates external data sources to ensure exchange of data (i.e. labs, claim...
Molina Healthcare Long Beach, CA
MOLINA HEALTHCARE- PROGRAM MANAGER -MMR-HEDIS EXP IS REQUIRED -REMOTE POSITION Job Summary The Program Manager of MRR plays an essential role in ensuring the accuracy and completeness of the organization's HEDIS medical records collection and is able to support the organization's risk adjustment quality assurance efforts. Both roles are critical because high levels of accuracy and completeness e...
Molina Healthcare Columbus, OH, 43231
MOLINA HEALTHCARE- CARE REVIEW CLINICAN II- COLUMBUS, OH Job Summary Works with the Utilization Management team primarily responsible for inpatient 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 that require hospi...
Molina Healthcare Long Beach, CA, 90802
MOLINA HEALTHCARE- PROGRAM MANAGER MMR- REMOTE POSITION Job Summary The Program Manager of MRR plays an essential role in ensuring the accuracy and completeness of the organization's HEDIS medical records collection and is able to support the organization's risk adjustment quality assurance efforts. Both roles are critical because high levels of accuracy and completeness ensures complete credit ...
Molina Healthcare Beaumont, TX
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...
Molina Healthcare Miami, FL
Job Summary The Supervisor will work with the manager of MRR Quality in setting medical records review standards that are to be applied to individual health plan and vendor projects. Essential Functions • Works with the Manager of Quality to set medical records review (MRR) standards for HEDIS for quality assurance purposes; assist with writing P&Ps to document standards for review by external ...
Molina Healthcare Columbus, OH, 44131
MOLINA HEALTHCARE- CASE MANAGER II- INDEPENDENCE, OH 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 c...
Molina Healthcare Columbus, OH
Job Summary Supervises a team of Provider Contract Specialists and Provider Contracts Coordinators to effectively create required contract documents according to standardized policies and procedures, documents all negotiations and implements/oversees tracking systems. Maintains standardized contract tracking system and publishes reports according to departmental procedures. Essential Functions ...
Molina Healthcare Long Beach, CA
Location: Long Beach, CA (Relocation Assistance is Available) Job Summary Under limited guidance the Sr Compensation Analyst assists in the development, implementation, and administration of compensation programs. This position is responsible for evaluating hourly and salaried positions for compliance with FLSA regulations. This position conducts job analysis to determine appropriate salary grad...
Molina Healthcare Seattle, WA
Job Summary Responsible for the daily configuration maintenance within the Configuration Information Management (CIM) Team. Accurately interprets specific State and/or Federal Benefits, Contracts as well as additional business requirements and converting these terms to configuration parameters. Also responsible for coding, updating and maintaining benefit plans, provider contracts, fee schedules ...
Molina Healthcare Irving, TX
Job Summary Accountable for understanding financial results and determining how to communicate results to benefit the financial performance of the organization. Responsible for preparing monthly financial and data analysis for senior management team. Includes reviewing of monthly financial results including performance related revenue calculations and premium reconciliation. Assists with complex ...
Molina Healthcare Sacramento, CA
Job SummaryThe Associate Medical Director (AMD) position is divided 50/50 with direct patient care (primary care) and administrative responsibilities as outlined below. Time is divided between centers and off site meetings, such as coordination meetings with Molina Medical Group Leadership and the Molina Health Plans. Availability for evening meetings with the corporate office or with other commun...
Molina Healthcare Long Beach, CA
Job Summary Participates with a team, or individually to develop or modify business requirements and functional specifications for business and software application and technology projects, including Business Requirements Documents (BRDs) and Functional Requirements Documents (FRDs). Assists project managers by managing sub-teams or a portion of an overall project. Generally works on small to med...
Molina Healthcare Long Beach, CA
Job Summary The Molina Healthcare Internship Program shares an objective to create a stepping stone for students and alumni who aim to be professionals and future leaders in the healthcare business profession. We aim to develop talent by providing students and alumni with experiential learning, formal training, and opportunities to interact with healthcare business professionals who will act as c...
Molina Healthcare Long Beach, CA, 90802
Job Summary Participates with a team, or individually to develop or modify business requirements and functional specifications for business and software application and technology projects, including Business Requirements Documents (BRDs) and Functional Requirements Documents (FRDs). Assists project managers by managing sub-teams or a portion of an overall project. Generally works on small to med...
Molina Healthcare Irving, TX
Job Summary Responsible for implementing and monitoring local QI and HEDIS interventions. Essential FunctionsThe position's essential functions are as follows: • Coordinates the preparation of annual HEDIS medical records project. • Coordinates medical record collection process with third party vendor and/or MHI. • Validates external data sources to ensure exchange of data (i.e. labs, claims ...
Molina Healthcare Columbus, OH, 43231
MOLINA HEALTHCARE - QI SPECIALIST III- INTERVENTIONS- COLUMBUS, OH Job SummaryResponsible for implementing and monitoring local QI and HEDIS interventions. Essential FunctionsThe position's essential functions are as follows: • Coordinates the preparation of annual HEDIS medical records project. • Coordinates medical record collection process with third party vendor and/or MHI. • Validates ex...
Molina Healthcare Columbus, OH, 43231
MOLINA HEALTHCARE- HEALTHCARE ANALYST II- COLUMBUS, OH Job Summary Healthcare Analyst II is an individual contributor role that provides senior-level healthcare analysis for the state health plans, including quantification and analysis of health care costs, development and maintenance of databases and other sources of information for quality initiatives, accreditation efforts, and regulatory man...
Molina Healthcare Oak Brook, IL, 60523
MOLINA HEALTHCARE- CASE MANAGER I OAKBROOK, IL 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 ef...

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