Molina Healthcare jobs
Care Manager (RN) – CA State License AND Compact
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 strategy to provide quality and cost-effective member care.
Essential Job Duties
Completes comprehensive assessments of members per regulated timelines and determines wh...
Medical Director (Based in CA)
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 setting. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Determines appropriateness and medical ...
Patient Care Delivery (Los Angeles, CA)
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 communication to ensure each member receives personalized and efficient care in a comfortable setting.
Job Duties
Account Representative, Medicare Sales-LA-Fully bilingual-Spanish
JOB DESCRIPTION Job Summary
Provides support for Molina Medicare sales activities. Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within market areas to achieve revenue, profitability and retention goals. Adheres to ethical sales practices, compliance with Centers for Medicare and Medicaid Services (CMS), and other regulatory requirements.
Essential Job Dutie...
Specialist, Facility Site Review (must reside in California)
Job Summary
Provides support for facility site review activities including routine document preparation and file management, site review meeting/travel scheduling, and office supply ordering. Facilitates activities including training and reporting, and supports projects and assignments aligned with functional facility site review processes and services. Provides feedback to leadership on facility site review program components...
Senior Medical Director (IPA- Based in CA)
JOB DESCRIPTION Job SummaryLeads and manages a team of medical directors delivering oversight and expertise in appropriateness and medical necessity of services provided to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care.
Position is based in California.
Essential Job Duties
Leads a team of medical directors responsible for assessing ap...
(RN)Healthcare Services Supervisor- Inpatient UM/UR (CA License Required)- REMOTE
JOB DESCRIPTION
Job Summary
Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to pr...
Senior Architect, Information Security – Azure/Cloud- Remote
Job Summary
The Senior Security Architect will be a key leader in designing, evaluating, and enforcing security controls across our enterprise cloud and network environments. This role will focus on security reviews, network change assessments, cloud security architecture, and policy development, ensuring alignment with industry best practices and regulatory requirements. The ideal candidate will have a passion for technology and security, along with a deep expertise in Azure clou...
Representative, Care Connections Member Advocate – Must Be Bilingual in Spanish – CA ONLY
Job Description
Please note the required shifts are Mon - Fri 10:00 AM 7:00 PM or Tues - Sat 7:00AM - 4:00PM Pacific Time Zone.
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