Browse current Molina Healthcare openings that JobDrop found directly from the company's careers source.
### Description JOB DESCRIPTION Job Summary Training: - 3 weeks of Remote Training: Monday-Friday: 9:00am – 5:30 pm EST (30 min. lunch) - 3 weeks of In-Person Training: Chinatown (30 East Broadway New York, NY 10002) Monday – Friday 9:00am – 5:30pm (30 min. lunch) Shift: Monday, Tuesday, Wednesday Off, Thursday, Friday
### Description JOB DESCRIPTION Job Summary Training: - 3 weeks of Remote Training: Monday-Friday: 9:00am – 5:30 pm EST (30 min. lunch) - 3 weeks of In-Person Training: Chinatown (30 East Broadway New York, NY 10002) Monday – Friday 9:00am – 5:30pm (30 min. lunch) Shift: Monday, Tuesday, Wednesday Off, Thursday, Friday
### Summary Must reside and be licensed in Washington
### Description 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 data stored within provid
### Description JOB DESCRIPTION Job Summary Provides senior level project management support for low to moderately complex business and/or technology projects. Responsible for supporting all phases of the project lifecycle, including planning, execution, monitoring, and closeout using standard project management method
### Description JOB DESCRIPTION Job Summary This role will be responsible for ensuring compliance with the State of Michigan Medicaid population health contract requirements, managing, tracking and monitoring CBO relationships, developing and disseminating collateral to support chronic condition management, data analys
### Description Job Description Position Overview The Lead Data Analyst plays a critical role in designing, implementing, and optimizing advanced data analytics solutions to support strategic and operational decision-making. This role partners closely with business, technology, and leadership teams to translate complex
### Description Job Summary Provides subject matter expertise and leadership for business and/or technology programs/projects. Leads all phases of the program lifecycle, including planning, execution, monitoring, and closeout, using standard project and program management methodologies and tools. Ensures alignment with
### Description JOB DESCRIPTION Job Summary Provides subject matter expertise for oversight, production, and resolution of health plan payment integrity (PI) recovery concepts. Executes and monitors health plan scoreable action items (SAIs) to ensure performance and quality levels exist in PI Business products and proc
### Description JOB DESCRIPTION Job Summary Provides support for provider network administration activities. Responsible for accurate and timely validation and maintenance of critical provider information on all claims and provider databases, and ensures adherence to business and system requirements of internal custome
### Description JOB DESCRIPTION Job Summary Responsible for comprehensive contract review and target claim audits review. This includes but not limited to; deep dive contract review and targeted claim audits related to accurate and timely implementation and maintenance of critical information on all claims and provider
### Description Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you’l
### Description Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you’l
### Description Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you’l
### Description 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 contributes to overarching strate
### Description 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 care in the most effective
### Description JOB DESCRIPTION Job Summary Provides entry level support for claims recovery activities. Responsible for claims data entry, inbox monitoring, and documentation support. This is an in-office role that requires travel to Molina offices to support administrative tasks related to the claims function. Essent
### Description JOB DESCRIPTION Family Care with My Choice Wisconsin Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members wi
### Description 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 quality and cost-effective m
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description 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 to overarching strategy
### Description JOB DESCRIPTION Job Summary Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. Essential Job Duties • Provides support for resolution of provider claims issu
### Description JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for Molina broker channel management activities. Responsible to build an effective and efficient broker channel for assigned geographical region in collaboration with other broker services and sales team members in assigned sta
### Description 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, ensuring timeliness, an
### Description JOB DESCRIPTION Opportunity for Texas licensed RN to join Molina as a Care Manager working with our Medicaid members in Dallas, TX. If hired, you will conduct face-to-face meetings with the members in their homes, completing assessments needed for determining the types of waiver services they are eligib
### Description JOB DESCRIPTION Job Summary Provides lead level engineering support for information technology (IT) big data architecture activities on Microsoft Azure cloud infrastructure. Representing as a Forward Deployed Engineer, responsible for leading the collection, storage, processing, and analysis of large he
### Description JOB DESCRIPTION Job Summary Provides senior level analysis for complex data to generate insights that support strategic and operational decision-making. This role designs and delivers reporting, analytics, and data solutions across business and healthcare domains, including claims, utilization, and fina
### Description JOB DESCRIPTION Job Summary This role is responsible for the internal business projects and programs involving departmental and cross-functional subject matter experts, delivering products from design through completion in support of new vendor implementation. Responsibilities include planning and direc
### Description Job Summary Provides strategy and leadership to team responsible for enterprise infrastructure operations, technology platforms, and engineering across all lines of business. Responsible for shaping the long‑term vision and roadmap for infrastructure capabilities, ensuring platforms are scalable, secure
### Description Job Description Job Summary Operates as a learning contributor who turns data into clarity. Applies structured thinking to explore healthcare and operational data and produce reliable insights that support decision-making, cost-containment strategies, and business performance improvement. Works with com
### Description Job Description The Manager, Process Improvement and Operational Excellence leads data-driven process optimization initiatives across Customer Experience, Marketing, Sales, and Agent Operations. This role partners closely with business, product, technology, analytics, and operational teams to identify g
### Description JOB DESCRIPTION Job Summary Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriat
### Description JOB DESCRIPTION Job Summary Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriat
### Description JOB DESCRIPTION Job Summary Provides general administrative support that includes routine document preparation, file management, scheduling/arranging meetings, arranging travel and ordering office supplies. This role serves as the lead for all regulatory reporting to the state across all lines of busine
### Description 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 for Medicare and Medicai
### Description ***Remote and must live in NY or the Tristate area*** 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 pe
### Description This is a remote field-based role requiring travel within Polk County. Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the contin
### Description JOB DESCRIPTION Job Summary Provides lead level 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 for Medicare
### Description 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 for Medicare and Medicai
### Description 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 for Medicare and Medicai
### Description 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 contributes to overarching strate
### Description 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 contributes to overarching strate
### Description Job Description Job Summary Leads and supervises a multidisciplinary team of healthcare services professionals supporting members with long-term services and supports (LTSS) needs - ensuring members reach desired outcomes through integrated delivery and coordination of care across the continuum. Contrib
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description 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 contributes to overarching strate
### Description 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 contributes to overarching strate
### Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to en
### Description JOB DESCRIPTION Job Summary Provides analyst support for Molina enterprise risk adjustment predictive analytics activities. Designs and develops suspect, targeting, and tracking system to support Molina’s prospective and retrospective interventions. Essential Job Duties • Assists risk adjustment data an
### Description 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 member progress toward desire
### Description 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 role includes coordination
### Description 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 member progress toward desire
### Description JOB DESCRIPTION Job Summary Provides engineering support for enterprise infrastructure systems through contributions to the implementation, maintenance, and reliability of platforms that enable critical business services across compute, storage, networking, cloud, and automation technologies. Collaborat
### Description JOB DESCRIPTION Highlights of requirements: - Fully remote position to conduct Prior Authorization reviews for services. - Open to candidates across the country, but you MUST have an active RN license in good standing in the state Illinois. - Priority will be given to candidates who have performed revie
### Description JOB DESCRIPTION Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for someone with a social services o
### Description JOB DESCRIPTION Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for someone with a social services o
### Description JOB DESCRIPTION Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for someone with a social services o
### Description JOB DESCRIPTION Job Summary Leads and manages 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 and production targets. Essen
### Description JOB DESCRIPTION Job Summary Leads and directs 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 to identify and track
### Description JOB DESCRIPTION Job Summary Provides senior 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 the Molina network. Respons
### Description 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 contributes to overarching strate