Molina Healthcare jobs
Representative, Care Connections Member Advocate – Must Be Bilingual in Spanish. Mon – Fri 10:00 AM 7:00 PM or Tues Sat 7:00 AM 4:00 PM Pacific Time Zone – CA ONLY
Job Summary
Makes outbound calls to members, completes assigned hand-dial lists, and provides proactive member support, information, and assistance. Adheres to member interaction departmental standards, call quality, and documentation requirements.
Job Duties
- Schedules high-quality member appointments daily to meet departmental goals.
- Completes assigned hand-dial lists and mem...
Healthcare Services Operations Support Auditor (LVN Required) – CA Only
JOB DESCRIPTION Job SummaryProvides support for non-clinical healthcare services auditing activities. Responsible for performing audits for non-clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Performs audits of non-clinical staff in utilization management, care management, member assessm...
Field Nurse Practitioner (Los Angles, CA)
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 desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Provides general medical care and car...
LVN UM Delegation Oversight Nurse Remote based in CA
JOB DESCRIPTION
Job Summary
Provides support for delegation oversight quality improvement activities. Responsible for overseeing delegated activities to ensure compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and requirements pertaining to delegation agreements. Contributes to overarching strategy to provide quality and cost-effectiv...
Analyst, Business Quality – SQL
Job Description
Job Summary
Assist business teams with developing requirements for major projects of considerable complexity, prepares system design specifications, conducts research to resolve customer initiated issues related to core systems processing, and coordinates and manages project teams in the development of large multi-system, multi-platform projects. This position is responsible for implementing the test approach, strategy ...
Transition of Care Coach (RN)
**California residency required in San Diego County.
JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progre...
Bilingual Growth & Community Engagement Specialist (South LA)
***Candidates For This Position Must Reside in/near the following areas: South LA, Downtown, Compton, Inglewood, Torrance, Watts***
***Bilingual, Any Language Accepted, Spanish preferred***
Are you passionate about serving and helping your community? Do you enjoy building relationships?
Molina Healthcareis hiring aSr Community Engagement & Growth Specialistin LA County (see listed locations). This important position is more than par...
Bilingual Growth & Community Engagement Spc. (Must Live near San Gabriel Valley, CA)
***Candidates For This Position Must Reside In/ LA County San Gabriel Valley area preferred***
***Bilingual Needed** Any language accepted with Cantonese/Mandarin preferred.
Are you passionate about serving and helping your community? Do you enjoy building relationships?
Molina Healthcareis hiring aSr. Growth & Community Engagement Specialistin LA County, in the San Gabriel Valley area.
This imp...
Care Review Clinician LVN
**California residents preferred. Candidates who do not live in California must be willing to work Pacific business hours.
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 desired outcomes through integrated delivery of ...