Browse current Molina Healthcare openings that JobDrop found directly from the company's careers source.
### Description JOB DESCRIPTION Job Summary The Molina Healthcare Internship Program shares an objective to create a steppingstone 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 lea
### Description JOB DESCRIPTION Job Summary Provides level II support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, identifies opportunities to
### Description JOB DESCRIPTION Job Summary Provides lead level analyst support for information technology (IT) systems activities. Responsible for the performance of systems analysis, application programming, and user training connected with the development and maintenance of automated data processing. Supports develo
### Description JOB DESCRIPTION Job SummaryProvides support for community-based member advocacy activities. Serves as a local member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing health care needs. Contributes to overarching strategy
### Description JOB DESCRIPTION ***Employee for this role must reside in Illinois***** Will support Labs, independent physician groups and specialist across the state of Illinois (except Cook County) Job Summary Provides subject matter expertise and leadership for health plan provider relations activities. Supports net
### Description JOB DESCRIPTION Job Summary Provides deep subject matter expertise and leadership for program management activities. Supports programmatic business needs across department and/or cross-functional areas, including programs design, implementation, administration, governance, workflow analysis, process imp
### Description JOB DESCRIPTION Job Summary Provides investigative support for special investigation unit (SIU) activities. Responsible for supporting for the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse (FWA). Responsible for re
### Description JOB DESCRIPTION Job Summary Provides support for member enrollment activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health plan selection and enrollment processes, processing paperwork and ensuring documentatio
### Description JOB DESCRIPTION Job Summary Provides senior level subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and con
### Description JOB DESCRIPTION Job Summary Leads and manages a regionally-based team of The Management Group's (TMG) IRIS consultants - ensuring provision of high-quality, person-centered supports to IRIS participants, and achievement of TMG's organizational goals. Contributes to overarching strategy to provide qualit
### Description Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you’l
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description Job Description Job Summary Provides lead level support for clinical validation review operations by assisting the Manager with workflow coordination, review consistency, calibration, training support, escalation, process improvement, and development of tools and resources that support timely, accurate,
### Description JOB DESCRIPTION Job Summary Leads and directs team responsible for enterprise infrastructure and information technology (IT) operations. Responsible for delivering reliable, high‑performing technology services across infrastructure, data, and operational support functions. Ensures service quality and pe
### Description JOB DESCRIPTION Job Summary Provides support for inpatient and outpatient clinical claim review activities. Verifies that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies accurately reflect the member's documented clinical condition, services rendered, and billed
### Description JOB DESCRIPTION Job Summary Provides entry level analyst support for provider configuration activities including accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data within multiple claims systems and validates data stored within provid
### Description JOB DESCRIPTION Job Summary Provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from hospital admission to all other settings. Strives to ensure that best possible services are available to members at time of hospital discharge,
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strate
### Description JOB DESCRIPTION Job Summary Leads and supervises a regionally-based team of The Management Group's (TMG) IRIS consultants - ensuring provision of high-quality, person-centered supports to IRIS participants, and achievement of TMG's organizational goals. Contributes to overarching strategy to provide qua
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina as a Field Care Manager to work with our Medicaid members in the service delivery area in Tyler, TX. You will complete assessments needed for determining the types of services our members are eligible to receive. Preference will be given
### Description JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina as a Field Care Manager to work with our Medicaid members in the service delivery area in Fort Worth. You will complete assessments needed for determining the types of services our members are eligible to receive. Preference will be give
### Description JOB DESCRIPTION Opportunity for a TX licensed RN with experience working in women’s health; specifically, OB, L&D, or postpartum, to join our Texas Health Plan as a Case Manager. Your caseload will consist of members who are pregnant, many of them high risk. Telephonically you will complete assessments
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strate
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description JOB DESCRIPTION Job Summary Provides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel most comfortable, including in-home, community and nursing facilities and “pop up” clinics. Strives to ensure member progress toward desire
### Description JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations, and ensuring members reach desired
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strate
### Description Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide qu
### Description JOB DESCRIPTION Job Summary Provides senior level support for health plan growth and community engagement activities. Responsible for achieving and continuously improving Molina’s enrollment/referral growth objectives across all lines of business; collaborates with key departments across the enterprise
### Description IRIS Consultant JOB DESCRIPTION Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for someone with a s
### Description Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you’l
### Description JOB DESCRIPTION Job Summary Provides level I support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, and identifies opportunities
### Description The role is a hybrid role with travel to member location assigned and meeting at Molina office once a month. The candidate must be located at one of the below Wisconsin (WI) locations: Spooner (Washington County), Park falls (Price County), Menomonie (Dunn County), New Auburn / Eau Claire (Chippewa coun
### Description This is a remote field-based role requiring travel in the Lawrence and Gallia County areas. Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member c
### Description JOB DESCRIPTION Job Summary Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for netw
### Description JOB DESCRIPTION Job Summary Provides entry level support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsi
### Description JOB DESCRIPTION Job Summary Provides lead level analyst support for vendor management activities. Responsibilities include monitoring key strategic/larger scale/more complex agreements from inception through completion, engaging and overseeing the work of external vendors, data analysis and solutioning
### Description JOB DESCRIPTION Job Summary Provides senior level support for benefit sales and enrollment activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health plan selection and enrollment processes, processing paperwork a
### Description JOB DESCRIPTION Job Summary Provides support for member growth and retention activities including provision of telephonic application assistance for new and existing members seeking to obtain or maintain health care coverage, and confirms information accuracy for eligibility. Provides information to mem
### Description Job Summary Leads and manages team responsible for Molina enterprise quality reporting activities for quality improvement initiatives. Oversees design and development of reporting solutions to support Star Rating and Healthcare Effectiveness Data and Information Set (HEDIS) auditing, rate tracking, iden
### Description JOB DESCRIPTION Job Summary Leads and manages team responsible for internal business projects from inception through delivery. Oversees project schedules, milestones, budgets, stakeholder involvement, and quality/delivery. Collaborates cross-functionally with departments and cross-functional teams of su
### Description JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for both members and providers and ensuring members receive the most appropriate care in the most effective
### Description JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for program management activities within Provider Network - with heavy use of Salesforce. Supports programmatic business needs across department and/or cross-functional areas, including programs design, implementation, administ
### Description JOB DESCRIPTION Job Summary Provides level III support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, identifies opportunities t
### Description JOB DESCRIPTION Job Summary Provides level II support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, identifies opportunities to
### Description JOB DESCRIPTION Job Summary Provides level II support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, identifies opportunities to
### Description JOB DESCRIPTION Job Summary Provides level II support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, identifies opportunities to
### Description JOB DESCRIPTION Job SummaryProvides support for community-based member advocacy activities. Serves as a local member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing health care needs. Contributes to overarching strategy
### Description JOB DESCRIPTION Job Summary Performs behavioral health utilization reviews, applying evidence-based criteria, and collaborating with physicians to ensure clinically appropriate, cost-effective, and regulatory-compliant care determinations. Assists in evaluating medical necessity, ensuring timeliness, an
### Description JOB DESCRIPTION Job Summary Provides support for community-based member advocacy activities. Serves as a local member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing health care needs. Contributes to overarching strategy
### Description JOB DESCRIPTION Job SummaryProvides support for community-based member advocacy activities. Serves as a local member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing health care needs. Contributes to overarching strategy
### Description JOB DESCRIPTION Job SummaryProvides non-clinical administrative support to the care management function, and contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective m
### Description JOB DESCRIPTION ***Employee for this role must reside in Michigan**** Job Summary Provides senior level support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and c
### Description Must be flexable to travel to the SC office when needed due to buisnsess needs JOB DESCRIPTION Job Summary Leads and manages team responsible for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in a
### Description JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for health plan provider network complex contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Responsible for negotiating agreements, inc