hckd.fa.us2.oraclecloud.com/CX_3002

Care Manager, LTSS (RN) - Field travel in Racine and Kenosha County,WI

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…

Specialist, Benefit Sales (Facilitated Enroller) (In Field - Bronx, NY)

JOB DESCRIPTION Job Summary Provides support for member enrollment activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health…

Hipaa

Care Manager - Must live in UT

Job Summary Responsible for reviewing Utah Medicaid claims data to identify members who meet Restriction Program criteria, including overutilization of emergency department services, multiple prescribers, multiple…

Care Manager, LTSS - Union County

North AmericaContract

This is a remote field-based role requirinig travel in the Union County area. May also include Decatur and Ringgold counties. Job Summary Provides support for care management/care coordination long-term services and…

Health Plan Provider Relations Manager (Physican Groups)

Contract Negotiation EDI Strategic Planning

JOB DESCRIPTION ***Employee for this role must reside in Illinois***** Will support Labs, independent physician groups and specialist across the state of Illinois (except Cook County) Job Summary Provides subject…

North AmericaFull-timeLead

Lead, Clinical Validation Reviewer (RN)

Job Description Job Summary Provides lead level support for clinical validation review operations by assisting the Manager with workflow coordination, review consistency, calibration, training support, escalation,…

Process Improvement

Director, IT Services - Network Engineering - Remote

ITIL PMP Process Improvement SDLC Six Sigma +3 skills

JOB DESCRIPTION Job Summary Leads and directs team responsible for enterprise infrastructure and information technology (IT) operations. Responsible for delivering reliable, high‑performing technology services across…

North AmericaFull-timeLead

Lead Analyst, IT Systems - IAM - Remote

Cloud C# Data Modeling .NET EDI +16 skills

JOB DESCRIPTION Job Summary Provides lead level analyst support for information technology (IT) systems activities. Responsible for the performance of systems analysis, application programming, and user training…

Specialist, Benefit Sales-Queens ,NY-Bilingual-French Creole/ South Asian

JOB DESCRIPTION Job Summary Provides support for member enrollment activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health…

Hipaa

Clinical Validation Reviewer (RN)

Analytics Process Improvement

JOB DESCRIPTION Job Summary Provides support for inpatient and outpatient clinical claim review activities. Verifies that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies…

Representative, Support Center II

CRM Hipaa Process Improvement Salesforce

JOB DESCRIPTION Job Summary Provides level II support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while…

North AmericaFull-timeSenior

Senior Manager, IRIS Consulting Services

Analytics Data Analytics Performance Management

JOB DESCRIPTION Job Summary Leads and manages a regionally-based team of The Management Group's (TMG) IRIS consultants - ensuring provision of high-quality, person-centered supports to IRIS participants, and…

RemoteNorth AmericaFull-time

IRIS Self-Directed Personal Care (RN) (Milwaukee County, WI)

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…

Telephonic Care Manager, LTSS (RN) - OB/Women's Health - TX ONLY

JOB DESCRIPTION Opportunity for a TX licensed RN with experience working in women’s health; specifically, OB, L&D, or postpartum, to join our Texas Health Plan as a Case Manager. Your caseload will consist of…

Care Manager (BH Licensed)

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…

Manager, National Quality Analytics & Reporting – Medicare Stars

Agile Analytics Data Analytics Data Mining Data Science +11 skills

Job Summary Leads and manages team responsible for Molina enterprise quality reporting activities for quality improvement initiatives. Oversees design and development of reporting solutions to support Star Rating and…

Manager, Projects (Medicare/Medicaid)

Agile AI PMP Process Improvement Six Sigma +1 skills

JOB DESCRIPTION Job Summary Leads and manages team responsible for internal business projects from inception through delivery. Oversees project schedules, milestones, budgets, stakeholder involvement, and…

North AmericaFull-timeSenior

Senior Program Manager (Salesforce Experience Required, Salesforce Certificate Preferred)

PMP Process Improvement Program Management Salesforce Six Sigma +2 skills

JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for program management activities within Provider Network - with heavy use of Salesforce. Supports programmatic business needs across…

Representative, Support Center II (Bilingual English/Spanish)

CRM Hipaa Process Improvement Salesforce

JOB DESCRIPTION Job Summary Provides level II support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while…