hckd.fa.us2.oraclecloud.com/CX_3002

Specialist, Benefit Sales (Facilitated Enroller) In Field - Monroe County, 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…

Care Manager, LTSS (RN-Pediatrics) NEW YORK

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…

Care Manager (RN) (Mississippi)

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…

Program Manager, PMO - Clinical/UM/CM/Pharmacy - Remote

Agile Certified ScrumMaster PMP Program Management Scrum +1 skills

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…

Program Manager (Population Health) - must reside in Michigan

Process Improvement Visio

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,…

Manager, Healthcare Services (RN) - Southern California is preferred

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be…

Care Manager (RN) (Omaha and Lincoln, NE)

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…

Care Manager (BH Licensed) (Champaign, IL)

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…

National Quality Performance Manager- HEDIS / SQL (Remote)

Analytics Azure Data Ingestion Data Quality PMP +2 skills

Job Summary Provides subject matter expertise for Molina's quality performance solutions team. Collaborates with various departments and stakeholders across the enterprise to plan, coordinate, and manage resources,…

Product Owner (EDI Solutions)

Acceptance Criteria Agile API Automation Azure +7 skills

Job Description Job Summary Provides subject matter expertise in the delivery, execution and maintenance of products. Accountable for maximizing the value of assigned technical products that support enterprise…

Care Manager - (RN, BH Licensed LCSW, LMHC, LMFT, LMSW) Multiple Openings in FL

North AmericaContract

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, Configuration (Production Support Team)

JOB DESCRIPTION Job Summary Leads a team of Custom Solution Production Support Analysts responsible for ensuring the stability, accuracy, and business performance of custom claims processing solutions. Oversees the…

Root Cause Analysis SQL

Product Owner (QNXT)

Acceptance Criteria Agile API Automation Azure +5 skills

Job Description Job Summary Provides subject matter expertise in the delivery, execution and maintenance of products. Accountable for maximizing the value of assigned technical products that support enterprise…

Program Manager, Healthcare Services (Clinical Policy and Medicare Compliance)

Process Improvement Program Management

JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring…

Care Manager (RN) Remote (Detroit, MI)

JOB DESCRIPTION This RN will act as a Care Manager supporting our Michigan Medicaid members, identified with complex medical needs. The Medicaid Care Manager will support them to ensure a successful health outcomes.…

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)

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,…

Care Manager, LTSS (RN) - Field travel in Grant, Iowa, Green 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…

Program Manager, Medicare Stars & Quality Improvement (Remote in Idaho)

ITIL Process Improvement Program Management Six Sigma

JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI…

Care Manager, LTSS (RN) (Bilingual Spanish) - Field travel in Milwaukee County, WI)

JOB DESCRIPTION Family Care with My Choice Wisconsin This opening is for a Bilingual Spanish speaking RN. Job Summary Provides support for care management/care coordination long-term services and supports…