JOB DESCRIPTION. Job Summary. Provides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions, and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members and identifies opportunities to maintain and increase member relationships. Recommends and implements programs to support member needs. KNOWLEDGE / SKILLS / ...
This job offer is not available in your country. JOB DESCRIPTION. Job Summary. Provides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions, and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members and identifies opportunities to maintain and increase member relationships. Recommends and implements progra...
Job Description. 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 progress toward desired outcomes with quality care that is medically appropriate and...
JOB DESCRIPTION. Job Summary. Provides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions, and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members and identifies opportunities to maintain and increase member relationships. Recommends and implements programs to support member needs. KNOWLEDGE / SKILLS / ...
Candidates For This Position Must Reside Near Counties In The Gulf Coast Area. Are you passionate about serving others. Do you have established relationships within the community. Come join our growing Community Engagement team at Molina Healthcare. Community Engagement is more than just participating in events at Molina, we focus on making an impact on people’s lives. This role involves working with a wide variety of community partners to grow M...
JOB DESCRIPTION. Opportunity for a Nebraska licensed RN to complete Inpatient Utilization Reviews for our behavioral health members. Preference will be given to those nurses who have experience doing these types of reviews within another Managed Care Organization and has experience working with behavioral health patients. This is a fully remote position, working from home, Monday – Friday, 8 AM – 5 PM CST and the opportunity is open to all qualif...
Remote and must live in Michigan. Job Description. Job Summary. Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Responsible for contracting/re-contrac...
JOB DESCRIPTION. Work Location - Remote within the United States. Job Summary. Responsible for planning, developing, and directing the implementation of techniques to ensure the maintenance of performance and quality levels in the Business' products and processes. Reviews operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve. KNOWLEDGE/SKILLS/ABILITIES. Oversee ...
JOB DESCRIPTION. Job Summary. Molina Healthcare Services (HCS) is required by CMS and state agencies to coordinate benefits when other carriers are responsible for payment. This requires the maintenance of other insurance records and has a direct impact on medical expenses and premium reimbursement. KNOWLEDGE/SKILLS/ABILITIES. Provides telephone, clerical, and data entry support for the Coordination of Benefits (COB) team. Phones or utilizes othe...
Job Description Job Summary. Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers...
JOB DESCRIPTION. Job Summary. Molina's Facilities function is responsible for the efficient planning, design, integration, and operation of the different elements that make up a work environment. Depending on location, this includes day-to-day facility operations management and administrative services (e.g., mailroom, reception, relocation/move support, maintenance/repair, etc.). physical security and safety. real estate administration and constr...
JOB DESCRIPTION. Job Summary. Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within approved market areas to achieve stated revenue, profitability, and retention goals, while following ethical sales practices and adhering to established policies and procedures. KNOWLEDGE/SKILLS/ABILITIES. Develop sales strategies to procure sufficient number of re...
