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
JOB DESCRIPTION Job Summary Provides support for member engagement and member retention activities. Represents members in areas involving member impact and engagement including: appeals and grievances and member issue research and resolution. Provides new and existing members w
hckd.fa.us2.oraclecloud.com
*Must reside in Mississippi* Remote position; Possible travel up to 25% in Mississippi
hckd.fa.us2.oraclecloud.com
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 ro
hckd.fa.us2.oraclecloud.com
Job Summary Leads and directs team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements. Collaborates closely wi
hckd.fa.us2.oraclecloud.com
Molina Healthcare is hiring for a Lead Analyst that will handle Provider and Facility Reimbursements . This team has oversight for all lines of business within our facility reimbursement scope. This team mixes some technical knowledge with operational oversight. Operational knowl
hckd.fa.us2.oraclecloud.com
Molina Healthcare of Ohio is hiring for a Sr Quality Improvement/HEDIS Specialist on our Health Plan Community Interventions team. This role is remote however candidates must live in Ohio. This role is laser focused on Quality Improvement using QI Science. This role will be assig
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 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 The role typically begins with a training period, during which the employee works closely with a Care Coordinator within their assigned region. Initial caseload expectations are approximately 40–45 members. Upon completion of training, the employee is provided wit
hckd.fa.us2.oraclecloud.com
Job Description Job Summary Performs focused clinical reviews of inpatient and outpatient claims to verify that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies accurately reflect the patient’s documented clinical condition, services rende
hckd.fa.us2.oraclecloud.com
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 net
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides support to Molina Vendor Operations through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion
hckd.fa.us2.oraclecloud.com
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 an
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION *****Employee for this role must reside in Florida***** Job Summary Leads and manages team responsible for Hospital Health Plan provider network contracting activities. Supports network strategy and development with respect to adequacy, financial performance and
hckd.fa.us2.oraclecloud.com
Description for Internal Candidates JOB DESCRIPTION ***This role will support hospital providers throughout Florida*** Job Summary Provides support for health plan hospital provider relations activities. Supports network development, network adequacy and provider training and edu
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides support to Molina MMISR IT 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 net
hckd.fa.us2.oraclecloud.com
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 ca
hckd.fa.us2.oraclecloud.com
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
hckd.fa.us2.oraclecloud.com
Job Description Job Summary Designs and implements reports and analyses to help the business team make informed decisions and meet regulatory requirements. Offers insight into key business problems and deliverables by applying statistical analysis techniques to examine structure
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 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 th
hckd.fa.us2.oraclecloud.com
***Remote and must live in the United States*** Job Description Job Summary Provides associate level support for legal counsel activities. Provides legal advisement related to rights, obligations, and privileges of the organization. Partners closely with legal and business stakeh
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Provides support for compliance auditing activities. Responsible for evaluating Molina's adherence to regulatory requirements, internal policies, and health care industry standards by identifying compliance gaps and recommending improvements to mitigate risk relat
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides senior level support for Molina Protection Services Operations Center (PSOC) enterprise applications. Responsible for executing and managing the applications that support physical security operations, business continuity management, crisis ma
hckd.fa.us2.oraclecloud.com
Molina Healthcare is hiring for a CSR for our Medication Therapy Management department. This role will be working Monday through Friday 10am to 630pm Mountain Standard Time. Highly qualified candidates will have exceptional customer service skills, great skills navigating Windows