Molina Healthcare jobs
Specialist, Health Plan Provider Engagement- HEDIS (Remote in CA)
JOB DESCRIPTION Job Summary
Provides support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes. Uses a consultative approach, emphasizing physician engagement and behavior change through actionable data and analytics. Drives value-based care strategies through risk adjustment and quality improvement activities. Focuses on smaller, less advanced Tier 2 and Tier 3 providers, ensuring they have e...
Broker Channel Manager-LA-Bilingual-Spanish
JOB DESCRIPTION Job Summary
Provides subject matter expertise and leadership for Molina broker channel management activities. Responsible to build an effective and efficient broker channel for assigned geographical region in collaboration with other broker services and sales team members in assigned states. Develops a high functioning, high performing broker network that is strategically aligned with Molinas mission and values by utilizing a combination of recruitment, mentoring...
Representative, Care Connections Member Advocate (Bilingual in Spanish, Arabic, Cantonese, Korean, or Tagalog) – Onsite in Long Beach, CA
Please note the required shifts are Mon - Fri 10:00 AM 7:00 PM or Mon - Fri 5:00AM - 2:00PM 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
Representative, Care Connections Member Advocate – Must Be Bilingual in Spanish (Onsite in Long Beach, CA)
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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Coordination of Benefits Processor (Managed Care) Remote
Molina Healthcare is hiring for Coordination of Benefits Processor. This role is remote and can be worked from a variety of locations. PST Time Zone is preferred.
This role will provide support for coordination of benefits review activities that directly impact medical expenses and premium reimbursement. Responsible for primarily coordinating benefits with other carriers responsible for payment. Facilitates administrative support, data entry, and accurate mai...
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.
Determines appropriateness and medical nece...
Medical Assistant, Care Connections – CA ONLY
JOB DESCRIPTION Job Summary
Provides medical assistant support for Care Connections team. Responsible for contacting members following appointments/services rendered to ensure member understanding and navigation of the health care system, and coordination support for follow-up care. Also provides assistance for other administrative clinical support tasks. Contributes to overarching strategy to provide quality and cost-effective member care.
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