Browse Jobs
Browse fresh roles from company career pages, then filter by keyword, location, salary, skills, remote scope, and more. Each listing links back to the employer-controlled apply path when available.
Browse fresh roles from company career pages, then filter by keyword, location, salary, skills, remote scope, and more. Each listing links back to the employer-controlled apply path when available.
hckd.fa.us2.oraclecloud.com
Provides support for community-based member advocacy activities with regard to transitioning from children services to adult services and preparing for adult responsibilities. Serves as a local member advocate and resource, using knowledge of the community and resources available
hckd.fa.us2.oraclecloud.com
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 contribut
hckd.fa.us2.oraclecloud.com
Job Description Job Summary The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute performa
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides analyst support for delegation oversight activities including monitoring delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements. Responsible for gathering, coord
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Leads and manages 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. Collaborates with health p
hckd.fa.us2.oraclecloud.com
**California resident required. Some travel may also be required in the state of California.
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides support for clinical liaison delegation oversight activities in conjunction with enterprise partners and multidisciplinary team coordinating integrated delivery of care across the continuum. Contributes to overarching strategy to provide quali
hckd.fa.us2.oraclecloud.com
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
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Behavioral Health experience required. 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 re
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides senior level support for delegation oversight activities. Oversees delegated activities to ensure compliance with state, federal, contractual, National Committee for Quality Assurance (NCQA), and Molina requirements. Essential Job Duties • Un
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Leads the design, development, and standardization of healthcare data assets supporting Medical Economics, Finance, Actuarial, and operational business functions. This role is responsible for driving scalable data frameworks, governance practices, and
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job SummaryLeads and manages a team of medical directors delivering oversight and expertise in appropriateness and medical necessity of services provided to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Responsible for leading the refinement, operationalization, and stewardship of enterprise healthcare datasets for Medical Economics use cases. This role focuses on transforming foundational enterprise data assets into trusted, business-ready datasets a
hckd.fa.us2.oraclecloud.com
Job Description Job Summary Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and deploying reports to provider networks and other end users for operational and strategic analysis. Kn
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Must reside in Florida. Provides 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
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and app
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need pote
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need pote
hckd.fa.us2.oraclecloud.com
***Remote with member visits throughout Pierce & St. Croix Counties, WI*** JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated d
hckd.fa.us2.oraclecloud.com
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 - ensu
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud and abuse investigations of medical providers using informatio
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Moni
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides support and ownership for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities and improve financial performance. Essential Job Duties • Extracts
hckd.fa.us2.oraclecloud.com
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 a
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Manages 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. Collaborates with health plans ident