Browse current Molina Healthcare openings that JobDrop found directly from the company's careers source.
### Description JOB DESCRIPTION Job Summary Provides senior-level accounting support for Molina's Texas Health Plan, including month-end close, account reconciliations, financial statement preparation, statutory reporting, audit support, and accounting schedule preparation. This role requires strong technical accountin
### Description Molina Healthcare is hiring for a Business Analyst, Provider Network. Highly qualified candidates will have the following experience: - Salesforce knowledge, a certification is helpful - Managed Care / Healthcare experience in the Provider space. - Business Operations experience. Job Summary Responsible
### Description Job Description Job Summary Perform data and error analysis to improve models, and clean and validate data for uniformity and accuracy. Execute data science and statistical analytical experiments methodically to help solve various problems and make a true impact across various healthcare domains. Develo
### Description JOB DESCRIPTION Job Summary Provides strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with h
### Description Job Description Please note the required shifts are Mon - Fri 10:00 AM– 7:00 PM or Mon - Fri 5:00AM - 2:00PM Pacific Time Zone. Job Summary Makes outbound calls to members, completes assigned hand-dial lists, and provides proactive member support, information, and assistance. Adheres to member interacti
### Description JOB SUMMARY JOB SUMMARY: The Lead Analytics Engineer designs and supports business-owned analytic capabilities that power critical Risk Adjustment functions including member targeting, workflow management, operational reporting, and regulatory support. Through close partnership and collaboration with co
### 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 This is a remote field-based role requiring daily travel. 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
### Description JOB DESCRIPTION Job Summary Provides senior-level analytical support for Medical Economics initiatives through the extraction, analysis, and synthesis of complex healthcare data to identify risks, opportunities, and drivers of medical cost and utilization trends. Responsible for developing actionable in
### Description JOB DESCRIPTION Job Summary Leads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensurin
### Description JOB DESCRIPTION Candidates must reside in Florida and hold an active, unrestricted nursing license in the state. This is a hybrid position requiring approximately 20% travel to hospital settings to support member needs. Applicants must have a minimum of two years of case management experience, specifica
### Description JOB DESCRIPTION Job Summary Provides senior-level analytical support for Medical Economics initiatives through the extraction, analysis, and synthesis of complex healthcare data to identify risks, opportunities, and drivers of medical cost and utilization trends. Responsible for developing actionable in
### 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 non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member
### Description JOB DESCRIPTION Must reside in Florida Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desir
### Description JOB DESCRIPTION Family Care with My Choice Wisconsin 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 wi
### Description JOB DESCRIPTION Field travel with My Choice Wisconsin 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 w
### Description Job Description Job Summary Provides lead level analyst support as a technical leader responsible for designing, developing, and delivering advanced data and reporting solutions to support strategic decision-making. Analyzes complex datasets including healthcare, financial, and operational data to ident
### Description JOB DESCRIPTION Acting as a Care Manager supporting our NM Medicaid members. The Medicaid Care Manager will support them to ensure management of health conditions. The position is a combination of phone call outreach and in person meetings with the members. Excellent computer skills and attention to det
### Description JOB DESCRIPTION Job Summary Leads a team of Custom Solution Production Support Analysts responsible for ensuring the stability, accuracy, and business performance of custom claims processing solutions. Oversees the review and resolution of production support issues through root cause and impact analysis
### Description JOB DESCRIPTION Job Summary Leads and directs Strategic and Clinical Analytics team members in Medical Economics who are responsible for healthcare analytics and program evaluation, translating complex data into actionable insights that inform clinical, operational, and strategic decision-making. Partne
### Description JOB DESCRIPTION Job Summary Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare
### Description Job Description Job Summary Leads the creation of a long-term strategic roadmap for the architecture of all IT systems. Knowledge/Skills/Abilities • Participates as a top level technical expert in leading multiple consulting projects or a single large/complex project and ensures the success of enterpris
### Description JOB DESCRIPTION Job Summary Provides lead level analyst support for configuration oversight activities. Responsible for accurate and timely implementation and maintenance of critical information on claims/provider databases, validating data housed on databases and ensuring adherence to business and syst
### Description JOB DESCRIPTION Job Summary Provides support to Molina functional areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion networks, as applicable.
### Description Job Description Job Summary Provides subject matter expertise in the delivery, execution and maintenance of products. Accountable for maximizing the value of assigned technical products that support enterprise operations. Owns the product vision, backlog, and delivery outcomes and serves as the primary
### 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 Job SummaryProvides peer support services for members with behavioral health needs/chemical dependency issues. In collaboration with multidisciplinary care team working across the continuum, strives to ensure member progress toward desired outcomes, and contributes to overarching strateg
### Description JOB DESCRIPTION This RN will act as a Care Manager supporting our Michigan Medicaid members, identified with complex medical needs. The Medicaid Care Manager will support them to ensure a successful health outcomes. The position includes telephonic outreach to members to conduct health assessments, iden
### Description JOB DESCRIPTION Job Summary Provides 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 contractual comm
### 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 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 strategy and leadership to team responsible for enterprise project and portfolio management activities. Oversees project and portfolio management across mergers and acquisitions (M&A), growth, and other business initiatives - ensuring successful delivery of programs
### Description JOB DESCRIPTION Hybrid role with approximately 10% local travel within King County. Candidates should have care management experience in Pediatrics, NICU, or Private Duty Nursing, with responsibility for managing a caseload of 30-35 members. Prior experience working remotely in a care management or clin
### Description JOB DESCRIPTION Job Summary Responsible for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination
### Description JOB DESCRIPTION Job Summary Provides support for Molina enterprise-wide employee training facilitation activities. Responsible for delivering structured training programs that support role-based onboarding, upskilling, and reinforcement of operational or soft-skill content. Facilitates learning through
### Description JOB DESCRIPTION Job Summary Provides strategy and leadership to team responsible for the development and administration of state health plan operational functions, programs and services - ensuring functional operations, contractual compliance, and alignment with health plan member satisfaction, retentio
### Description JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiatives and education programs to support improved Medicare Star ratings. Responsible fo
### Description JOB DESCRIPTION Job Summary Provides administrative level support to an Executive and division team members. Prioritizes management/client requests in order to meet business objectives. Supports the day-to-day administrative operations of the Executive and department. Job Duties - Composes routine execu
### Description JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicai
### Description JOB DESCRIPTION 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 contracted providers within the Molina network. Respons
### Description Job Description Job Summary Provides support through the investigation and resolution of disputes related to provider appeals, ensuring that claims adhere to correct billing standards and regulations. Job Duties - Reviews coding-related provider claims denials by systematically examining medical records
### Description ***Remote and must live in the United States*** JOB DESCRIPTION Job Summary Leads and directs team responsible for the delivery, execution and maintenance of products. Accountable for maximizing the value of assigned technical products that support enterprise operations. Leads the product vision, backlo
### Description JOB DESCRIPTION Acting as a Care Manager supporting our NM Medicaid members. The Medicaid Care Manager will support them to ensure management of health conditions. The position is a combination of phone call outreach and in person meetings with the members. Excellent computer skills and attention to det
### Description JOB DESCRIPTION Candidates must hold a current California license, reside in the San Diego, California area, and be able to travel up to 10% as required. The ideal candidate will have 2 to 3 years of leadership experience within a managed care organization, with a proven ability to lead teams, drive per
### Description JOB DESCRIPTION Job Summary Provides support for pharmacy technician activities. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties • Performs initial receipt and review of non-formulary o
### 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 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 support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through int
### Description Job Description Job Summary The Lead Data Analyst serves as a senior individual contributor responsible for complex healthcare analytics supporting Medicare Stars, provider incentive programs, member outreach campaigns, and enterprise performance reporting. This role requires advanced analytical skills,
### 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 JOB DESCRIPTION Job Summary Provides support for member correspondence activities. Responsible for generating clinical determination letters for members and providers, and following established guidelines and standards related to correspondence processing. Contributes to overarching strategy to provide
### Description JOB DESCRIPTION Job Summary Provides support for provider network administration activities. Responsible for accurate and timely validation and maintenance of critical provider information on all claims and provider databases, and ensures adherence to business and system requirements of internal custome
### Description JOB DESCRIPTION Job Summary MUST CURRENTLY RESIDE IN KENTUCKY Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. Essential Job Duties • Provides support for
### Description Molina Healthcare is hiring for remote Certified Pharmacy Technicians. These roles will be in our Prior Authorization department. You will review prior auth requests that are submitted. Schedules for these roles will be Mon through Fri 11am-7:30pm MST or 12:30pm-9pm MST. The training schedule will be ap
### Description JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicai
### Description JOB DESCRIPTION Opportunity for TX RN to join Molina as a Care Manager working with our Medicaid members in the southern part of the Dallas, TX service delivery area. Communities serviced will be Lancaster, Seagoville, Red Oak, and DeSoto. Responsibilities include completing in-home, face-to-face assess
### Description JOB DESCRIPTION Opportunity for TX LVN, LBSW, LMSW to join Molina as a Care Manager working with our Medicaid members in the southern part of the Dallas, TX service delivery area. Communities serviced will be Lancaster, Seagoville, Red Oak, and DeSoto. Responsibilities include completing in-home, face-t
### 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 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