Molina Healthcare Jobs & Careers

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93 Molina Healthcare jobs found on Monster.

Jobs 1 to 20 of 93
Molina Healthcare San Antonio, TX
Job Summary Responsible for coordinating the assigned aspects of the credentialing and primary source verification process for practitioners and health delivery organizations according to Molina policy and procedures. Essential Functions Duties will be assigned as pertains to the individual employee's respective role from within the below with the possibility of additional duties being assigned...
Molina Healthcare Charleston, SC
Job Summary The Medical Records QA Specialist will review medical records and performs assessments to determine errors in the records. Essential Functions • Skilled use of HEDIS software for data entry, over reading, QA queries • Reviews medical records to ensure standards are met as defined by NCQA , Molina, and external auditor. • Identifies standards met and gaps against external auditor s...
Molina Healthcare Miami, FL
Job Summary The Manager of Member Services provides guidance oversight to Member Services Supervisors and staff to ensure the department meets the company's Strategic Goals while modeling Molilna's Core Values. The Manager analyzes reports to identify trends an opportunities. Essential Functions • Manage call center operations • Provide exemplary customer service to customers including members...
Molina Healthcare Columbus, OH
Job Summary Under direct supervision, provides general administrative support to a department or group of professionals. Compiles and analyzes basic information for inclusion in reports or presentation materials,prepares charts, graphs, or tables as necessary. Receives and responds to routine correspondence following established procedures not requiring management review. Requires the ability to ...
Molina Healthcare Columbus, OH
Job Summary Works within the Care Access and Monitoring (CAM) team to provide clerical and data entry support for Molina Members that require hospitalization and/or utilization review for other healthcare services. Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate Health Care Services staff to...
Molina Healthcare Wenatchee, WA, 98801
** Remote position, ideal candidate will live in Chelan County and have experience coordinating local community resources ** Job Summary Under minimum supervision, serves as a community based member advocate and resource and a vital part of the Integrated Molina Healthcare Care Team. Provides outreach to locate and/or provide support for disconnected members with special needs. Educates members ...
Molina Healthcare West Allis, WI
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 Midvale, UT
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 West Allis, WI
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 West Allis, WI, 53227
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 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 int...
Molina Healthcare Salt Lake City, UT
Job SummaryThe 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 re...
Molina Healthcare Midvale, UT, 84047
Job Summary Assists the Director with ensuring the Molina Medicaid plans maintain NCQA Accreditation and bring new or acquired plan to NCQA Accredited status. The Manager maintains tracking of State QI activities and ensures timely completion within appropriate Corporate standards. The Manager maintains the library of accreditation and regulatory updates from NCQA, CMS and state regulators. The M...
Molina Healthcare Greenville, SC
Job Summary Under minimum supervision, serves as a community based member advocate and resource and a vital part of the Integrated Molina Healthcare Care Team. Provides outreach to locate and/or provide support for disconnected members with special needs. Educates members and is an advocate for vulnerable members, engaging and assisting them in managing their healthcare needs. Provides non clinic...
Molina Healthcare Charleston, WV
Job Summary Acts as the liaison between the customer, the provider community and other health care representatives. Supports all aspects of the relationship including trouble shooting and client manual/policy knowledge. Essential Functions o Handles heavy inbound call volume with knowledge to address more complex concerns from Provider Community. o Interacts with providers, in a timely and pro...
Molina Healthcare Charleston, WV
Job Summary Responsible for answering all calls from providers regarding eligibility and benefits in a call center setting, and to satisfactorily resolve calls within expected response time standards. May also answer and resolve calls from members. Essential Functions o Handles heavy inbound call volume. o Responds to incoming calls mainly from providers, and on occasion from members, as requi...
Molina Healthcare Irving, TX
Job Summary Oversees the design, implementation and evaluation of quality improvement related initiatives. This position is responsible for the development of targeted interventions related to HEDIS performance improvement. These targets include member and provider outreach to improve care/service. Responsible to develop and implement MHI medical record pursuit strategies, processes and over see t...
Molina Healthcare Charleston, SC
POSITION SUMMARY: Responsible for the generation and preparation of Provider Related data and reports in support of Network Management and Operations Department areas of accountability. Also responsible for timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and...
Molina Healthcare Miami, FL
Job Summary Under general supervision, is responsible for improving overall quality and completeness of clinical documentation, performs assessments to determine errors in the records. Essential Functions• Initiates and performs concurrent documentation review of selected records to clarify where inadequate or conflicting documentation is suspected. • Escalates errors to Mgr, AVP and VP in timel...
Molina Healthcare Houston, 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 )...

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