Molina Healthcare

Provides administrative level support to an Executive and division team members. Prioritizes management/client requests in order to meet business objectives. Supports the day-to-day administrative operations of the Executive and department. Composes routine executive corresponden...

The Care Manager provides support for care management and care coordination for long-term services and supports, collaborating with a multidisciplinary team to deliver integrated care across the continuum for high-need members. Essential duties include completing comprehensive member assessments, developing and implementing care plans, and monitoring their effectiveness to ensure progress toward desired outcomes.

This role supports medical records collection activities, primarily through outreach to providers via phone, fax, mail, EMR retrieval, and on-site pickup for HEDIS-specific data collection and quality improvement projects. Responsibilities also include loading collected records into the HEDIS application and providing project management support for data pursuit and collection.

Leads and directs team responsible for health plan provider network contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Collaborates with senior leadership and the corporate network managem...

Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role include...

Provides senior level clinical support to quality team - contributing to quality management programs, initiatives, audits, data analysis and quality improvement surveys and state/federal quality compliance activities. Contributes to overarching strategy to provide safe, efficient...

The Quality Program Management and Performance Manager develops and implements new and existing healthcare quality improvement activities to maintain compliance with quality program requirements and reporting and monitoring for key quality program activities. Acts as a subject ma...

The Provider Engagement Specialist role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures assigned Tier 2 & Tier 3 providers have a Provider Engagement plan to mee...

The Specialist, Member & Community Interventions implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid). Executes health plan’s member and community quality focused interventions and programs ...

A Lead Data Engineer collaborates with the Data Quality and Governance team to ensure data pipelines, data integrity, and compliance by defining data strategies, implementing Data Governance capabilities, creating self-service data assets, and integrating robust data quality and ...