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
Must have current RN license and reside in MA
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 Leads and manages team responsible for special investigation unit (SIU) activities, specifically the prevention and detection of violation of applicable laws and regulations. Responsible to protect the business from liability of fraudulent or abusive practices, an
hckd.fa.us2.oraclecloud.com
Job Description Job Summary Under general supervision, this position has lead responsibilities for accessing, integrating, data compilation, data management, data analysis, data quality controls and reporting from various Molina Healthcare systems (e.g., QNXT, and Med Insight) an
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Responsible for leveraging the technology for the benefit of the business. Interface and manage strategic relationships with business partners by representing & promoting IM capabilities. KNOWLEDGE/SKILLS/ABILITIES Builds and maintains effective and tr
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Role Summary This role provides dedicated engineering ownership for Molina’s Secure Access Service Edge (SASE) platform and enterprise data protection capabilities, with supporting responsibility for endpoint resilience technologies such as Dell Absolute. The posi
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary This RN will act as a Transition of Care Coach supporting our Michigan Medicare and Dual members who have recently been admitted to this hospital. The TOC Coach will support them to ensure a successful transition from inpatient to discharge to either a
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides support for provider denial coding dispute activities. Investigates and resolves disputes related to provider appeals, and ensures that claims adhere to correct billing standards and regulations. Essential Job Duties • Reviews coding-related
hckd.fa.us2.oraclecloud.com
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 overarchi
hckd.fa.us2.oraclecloud.com
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 overarch
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides senior level analyst support for finance activities including financial analysis, reporting, forecasting, trending and modeling to support planning for future business decisions such as new product development, marketing strategies and investm
hckd.fa.us2.oraclecloud.com
Must be RN and reside in California
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides deep subject matter expertise and leadership for competitor analysis activities for Molina request for proposals (RFPs) for new or reprocuring business. Leads Molina competitive intelligence and analysis related to business development activi
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides senior level support for government contracts activities. Responsible for the development and administration of contracts with state and/or federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to pr
hckd.fa.us2.oraclecloud.com
Job Description Please note the required shifts are Mon - Fri 10:00 AM– 7:00 PM or Tues - Sat 7:00AM - 4:00PM Pacific Time Zone. Job Summary Makes outbound calls to members, completes assigned hand-dial lists, and provides proactive member support, information, and assistance. A
hckd.fa.us2.oraclecloud.com
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 agree
hckd.fa.us2.oraclecloud.com
***Remote and must live in Washington*** 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 op
hckd.fa.us2.oraclecloud.com
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 qual
hckd.fa.us2.oraclecloud.com
Job Summary Molina Healthcare Services (HCS) is required by CMS and state agencies to coordinate benefits when other carriers are responsible for payment. This requires the maintenance of other insurance records and has a direct impact on medical expenses and premium reimburseme
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Leads and supervises team responsible for payment integrity activities including recovery operations. Responsible for performance, quality levels and establishing procedures and techniques that achieve optimal payment integrity operational standards a
hckd.fa.us2.oraclecloud.com
Job Description Job Summary Provides support in conducting research, analysis, and reporting across healthcare and operational data to support decision‑making, cost‑containment strategies, and business performance improvement. Works with complex datasets including claims, pharmac
hckd.fa.us2.oraclecloud.com
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
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Focuses on process improvement, organizational change management, project management and other processes relative to the business. Project management includes estimating, scheduling, costing, planning, and issue/risk management. KNOWLEDGE/SKILLS/ABILIT
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 lead level analyst support for configuration information management activities. Responsible for accurate and timely implementation and maintenance of critical information on claims databases, synchronizing operational and claims systems data