Molina Healthcare jobs
Specialist, Patient Care Delivery (San Diego, 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
Supervisor, Healthcare Services
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 provide quality and cost-...
Care Review Clinician (RN)
JOB DESCRIPTION Job SummaryProvides 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 care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Assesses services...
Representative, Care Connections Member Advocate – Must Be Bilingual in Spanish – CA ONLY
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
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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...
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...