Molina Talent Acquisition

Job Summary Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and di…

Molina Healthcare of Ohio is hiring for a Sr Quality Improvement/HEDIS Specialist on our Health Plan Community Interventions team. This role is remote however candidates must live in Ohio. This role is laser focused on Q…

Molina Healthcare is hiring for a Lead Analyst that will handle Provider and Facility Reimbursements. This team has oversight for all lines of business within our facility reimbursement scope. This team mixes some te…

Job Summary Leads and directs team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Ass…

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,…

Job Summary Leads and directs team responsible for value-based programs (VBP) activities. Responsible for developing and implementing value-based strategies for lines of business impacted by the regulatory risk adjus…

Job Summary Provides support for community-based member advocacy activities. Serves as a local member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable me…

JOB DESCRIPTION Job Summary Focuses on process improvement, organizational change management, project management and other processes related to the business. Project management includes estimating, scheduling, co…

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 membe…

JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiati…

JOB DESCRIPTION The role typically begins with a training period, during which the employee works closely with a Care Coordinator within their assigned region. *Initial caseload expectations are approximately 40–45 mem…

Job Description Job Summary Designs and implements reports and analyses to help the business team make informed decisions and meet regulatory requirements. Offers insight into key business problems and deliverabl…

Molina Healthcare is hiring for a CSR for our Medication Therapy Management department. This role will be working Monday through Friday 10am to 630pm Mountain Standard Time. Highly qualified candidates will have exceptio…

Job Summary Provides analyst support for compliance activities. Seeks to ensure the organization adheres to regulatory requirements, industry standards, and Molina internal policies, and prevent and/or detect violati…

Job Summary Provides analyst support for clinical policy review activities. Supports review and evaluation processes of existing clinical policies, proposes suggested improvements to existing policies, and facilitate…

Job Description Provides support for compliance auditing activities. Responsible for evaluating Molina's adherence to regulatory requirements, internal policies, and health care industry standards by identifying comp…

Job Summary Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare uti…

Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standa…

Job Summary Provides entry level support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between t…

Job Summary Provides associate level support for legal counsel activities. Provides legal advisement related to rights, obligations, and privileges of the organization. Partners closely with legal and business stakeh…

Job Summary Provides strategy and leadership to team responsible for value-based contracting (VBC) activities. Responsible for valuating, negotiating, implementing and expanding the organization’s VBC portfolio acros…

JOB DESCRIPTION Job Summary Provides senior level support for Molina Protection Services Operations Center (PSOC) enterprise applications. Responsible for executing and managing the applications that support physical sec…

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 pr…

Job Summary Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and di…

JOB DESCRIPTION Job Summary Leads and manages team responsible for Molina enterprise learning and development activities. Oversees the development, administration, and implementation of employee learning/training program…

Job Summary Leads and manages team responsible for Molina sales and distribution activities. Responsible for increasing membership through direct sales and marketing of Molina products within approved market areas to…

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 membe…

Come join us for our upcoming virtual hiring event! Event Date & Time: Thursday, June 25th at 12:00pm EST Register here today: [Florida Care Manager Virtual Hiring Event – Molina Healthcare](https://app.brazencon…

Job Summary Provides analyst support for health plan risk and quality reporting activities. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of in…

Job Summary Provides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel most comfortable, including in-home, community and nursing faciliti…

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 membe…

Job Summary Provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from hospital admission to all other settings. Strives to ensure that best po…

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 collabo…

Job Summary This position will offer remote work flexibility, but the selected candidate must reside in Florida. Candidates for this position should be available and willing to work a shift which will include Saturda…

JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as pr…

Job Summary Provides senior level analyst support for Molina enterprise risk and quality reporting activities. Designs and develops reporting solutions to support Healthcare Effectiveness Data and Information Set (HE…

Job Summary Provides non-clinical administrative support to the care management function, and contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum. Co…

Job Summary Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls, vendor prac…

Job Description Opportunity for a TX licensed RN, residing in Texas, with experience functioning as a Care Manager working with Complex/Intensive cases assisting with Disease Management. Telephonically you will compl…

Job Summary Provides senior level analyst support for advanced provider data management (PDM) activities including analyzing business processes related to PDM, identifying areas for improvement, and developing and im…

Job Summary Provides support to Molina functional areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance framewor…

JOB DESCRIPTION Job Summary Position collaborates daily with LTSS providers to include Adult Family Homes, Assisted Livings, Adult Day Care Centers, Ancillary Providers, and Nursing Homes in review of potential concerns…

Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hea…

Job Summary Provides investigative support for special investigation unit (SIU) activities. Responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money rela…

JOB DESCRIPTION Opportunity for a Texas licensed LVN to join Molina to work with our Medicaid members in the greater Dallas neighborhoods of Old East Dallas, Dolphin Heights, South Dallas service delivery area. You will…

Molina Healthcare is hiring for remote Certified Pharmacy Technicians. These roles will be in our Prior Authorization department. You will review prior auth requests that are submitted. Shift times for these roles will b…

Job Summary Provides subject matter expertise and leadership for health plan provider network complex contracting activities. Supports network strategy and development with respect to adequacy, financial performance…

Molina Healthcare is hiring a Lead, Medicare Administration. This will be a remote position on our team that is responsible for our Medicare product - both Bids and Member Materials. **Highly qualified candidates…

Job Summary Performs behavioral health utilization reviews, applying evidence-based criteria, and collaborating with physicians to ensure clinically appropriate, cost-effective, and regulatory-compliant care determin…

Job Description Opportunity for a Texas licensed RN to join Molina to work with our IDD members in the Houston service delivery area. Our Care Managers conduct face-to-face meetings with the members in their homes, c…