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 Performs behavioral health utilization reviews, applying evidence-based criteria, and collaborating with physicians to ensure clinically appropriate, cost-effective, and regulatory-compliant care determinations. Assists in evaluating medical necessity,
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina to work with our IDD members in the Houston service delivery area. Our Care Managers conduct face-to-face meetings with the members in their homes, completing assessments needed to determine the types of services
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides senior level support for government regulatory contracts activities. Responsible for the development and administration of contracts with state and/or federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored pro
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 Description Job Summary The Specialist, Patient Care Delivery is a multi-disciplinary healthcare professional who delivers high-quality, compassionate care to health plan members in their homes. This role combines clinical expertise, cultural sensitivity, and excellent commun
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides executive level strategy and leadership to the health plan in the development and execution of care management and utilization management programs. Develops clinical practice guidelines and oversees appropriateness and medical necessity of ser
hckd.fa.us2.oraclecloud.com
Job Description Job Summary Reporting to the Chief Digital Officer, the AVP Enterprise Architecture is responsible for designing and communicating the shared architectural vision and standards for the Information Technology organization to drive industry-leading capability at Mol
hckd.fa.us2.oraclecloud.com
Come join us for our upcoming virtual hiring event! Event Date & Time: Tuesday, June 9th at 12:00pm EST Register here today: Molina Healthcare Florida Virtual Hiring Event 1 Event Date & Time: Thursday, June 25th at 12:00pm EST Register here today: Molina Healthcare Florida Virtu
hckd.fa.us2.oraclecloud.com
Knowledge/Skills/Abilities Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment re
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 Description Job Summary The Specialist, Patient Care Delivery is a multi-disciplinary healthcare professional who delivers high-quality, compassionate care to health plan members in their homes. This role combines clinical expertise, cultural sensitivity, and excellent commun
hckd.fa.us2.oraclecloud.com
Job Summary This role will act as an advocate for Molina members and a subject matter expert about members’ extra benefits and covered services. The overarching driver will be increasing member retention and member satisfaction, and facilitating improvements in the health plan. U
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 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 operational performance. Responsible for n
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 DESCRIPTION Job Summary Will require to be infield twice a week subject to change 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 t
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 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 **This is a hybrid role. Since your team is based in Thurston/Mason County, you will also need to be located there.** Job Summary Provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from ho
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership 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
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides analyst oversight support for payment integrity post payment recovery concepts. Responsible for accurate and timely implementation and maintenance of the payment integrity post pay recovery concepts, validating data housed on databases and en
hckd.fa.us2.oraclecloud.com
Job Description Job Summary Leads solution design architectures for several applications – mapping business requirements to high level design covering technologies, services, and products. Design, describe, and manage the solution by collaborating with various delivery teams and
hckd.fa.us2.oraclecloud.com
JOB DESCRIPTION Job Summary Provides executive level strategy and leadership for the operational integrity and regulatory compliance of the organization’s risk adjustment operations across all lines of business, including Medicare Advantage, Medicaid, and Affordable Care Act (ACA
hckd.fa.us2.oraclecloud.com
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 n
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