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 Leads and supervises team responsible for configuration Oversight activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides support for Molina Medicare sales activities. Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within market areas to achieve revenue, profitab
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 Job Summary Provides senior level analyst support for Molina enterprise risk and quality reporting activities. Designs and develops reporting solutions to support Healthcare Effectiveness Data and Information Set (HEDIS) auditing, rate tracking, identification of
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 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
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides analyst support for health plan risk and quality reporting activities. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of initiatives. Educates users on how to use reports
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Must reside in Florida. Provides support for claims examination activities including evaluation of adjudication of claims to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors. Essential Job Du
hckd.fa.us2.oraclecloud.com
Come join us for our upcoming virtual hiring event! Event Date & Time: Thursday, June 25th at 12:00pm EST Register here today: Florida Care Manager Virtual Hiring Event – Molina Healthcare Event Date & Time: Wednesday, July 1st at 12:00pm EST Register here today: Florida Care Man
hckd.fa.us2.oraclecloud.com
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 desi
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 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 membe
hckd.fa.us2.oraclecloud.com
Job Summary 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 strategy to provide quality and cost-ef
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina to work with our Medicaid members in the greater Dallas neighborhoods of Westmoreland Heights and Cockrell Hill service delivery area. You will conduct face-to-face visits with members in their homes, completing a
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Opportunity for a Texas licensed LVN to join Molina as a Field Care Manager to work with our Medicaid members in the San Benito, TX serviced delivery area. You will complete assessments needed for determining the types of services the non-waiver members are eligib
hckd.fa.us2.oraclecloud.com
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 and around Baytown, Beach City, Highlands, Channelview, and La Porte, TX. You will complete assessments needed for determin
hckd.fa.us2.oraclecloud.com
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
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Opportunity for a Texas licensed LVN to join Molina to work with our Medicaid members in the greater Dallas neighborhoods of Old East Dallas, Dolphin Heights, South Dallas service delivery area. You will conduct face-to-face visits with members in their homes, com
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Opportunity for a Texas licensed LVN to join Molina as a Field Care Manager to work with our Medicaid members in the Laredo, TX serviced delivery area. You will complete assessments needed for determining the types of services the non-waiver members are eligible t
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina as a Field Care Manager to work with our Medicaid members in the Harlingen, TX serviced delivery area. You will complete assessments needed for determining the types of services the waiver members are eligible to
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Position collaborates daily with LTSS providers to include Adult Family Homes, Assisted Livings, Adult Day Care Centers, Ancillary Providers, and Nursing Homes in review of potential concerns in quality-of-service delivery to MCW members. Ensures provi
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides executive strategy and leadership to team responsible for network operations and contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Also responsible
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Candidates must reside in the Pacific Standard Time (PST) zone. The standard work schedule is 8:30 AM to 5:00 PM, with a rotating weekend requirement approximately every 7–9 weeks, which may include working a full weekend or a single weekend day. Prior authorizati
hckd.fa.us2.oraclecloud.com
Molina Healthcare is hiring a Lead, Medicare Administration . This will be a remote position on our team that is responsible for our Medicare product- both Bids and Member Materials. Highly qualified candidates will have the following experience: Medicare experience Experience fi