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Sr Analyst, Business - Member Enrollment (Medicaid & Medicare) - Remote

Molina Healthcare
Ohio
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**JOB DESCRIPTION****Job Summary**Analyzes complex business problems and ...
Details
Summary
About the job:
issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs. May participate in...
Location:
Ohio
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
Certified Business Analysis Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Reg Mgr, Value-Based Prgms

Molina Healthcare
Columbus, OH
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**JOB DESCRIPTION****Job Summary**The Regional Manager Value Based Programs ...
Details
Summary
About the job:
plays a critical role in the implementation of value-based programs and contracts by supporting both the local markets and national value based contracting team. Ensures smooth communication, supports proposal and counter-proposal development, tracks financial performance of existing programs and contracts, and ensures alignment with local health plan budgets and forecasts.Accountable for designing and implementing a strategy to continuously improve financial results of existing contracts and programs while also...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Financial Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Case Manager (RN)

Molina Healthcare
Ohio
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**JOB DESCRIPTION****Job Summary**Molina Healthcare Services (HCS) works ...
Details
Summary
About the job:
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 cost-effective based on the severity of illness and the site of service.**KNOWLEDGE/SKILLS/ABILITIES**+ Completes comprehensive assessments of members per...
Location:
Ohio
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
Certified Case Manager
Certified in Long Term Care
Driver's License
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Case Manager (RN): OHIO

Molina Healthcare
Dayton, OH
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*****Qualified candidate must reside and be willing to travel within the ...
Details
Summary
About the job:
following Counties in OHIO: Hamilton, Butler, Warren, Clermont, Montgomery, Greene, Clark and Clinton.****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...
Location:
Dayton, OH
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
Certified Case Manager
Certified in Long Term Care
Driver's License
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Reg Mgr, Value-Based Prgms

Molina Healthcare
Cincinnati, OH
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**JOB DESCRIPTION****Job Summary**The Regional Manager Value Based Programs ...
Details
Summary
About the job:
plays a critical role in the implementation of value-based programs and contracts by supporting both the local markets and national value based contracting team. Ensures smooth communication, supports proposal and counter-proposal development, tracks financial performance of existing programs and contracts, and ensures alignment with local health plan budgets and forecasts.Accountable for designing and implementing a strategy to continuously improve financial results of existing contracts and programs while also...
Location:
Cincinnati, OH
Job Type:
Full-Time
Permanent
Occupation:
Financial Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Reg Mgr, Value-Based Prgms

Molina Healthcare
Ohio
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**JOB DESCRIPTION****Job Summary**The Regional Manager Value Based Programs ...
Details
Summary
About the job:
plays a critical role in the implementation of value-based programs and contracts by supporting both the local markets and national value based contracting team. Ensures smooth communication, supports proposal and counter-proposal development, tracks financial performance of existing programs and contracts, and ensures alignment with local health plan budgets and forecasts.Accountable for designing and implementing a strategy to continuously improve financial results of existing contracts and programs while also...
Location:
Ohio
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Case Manager (RN): OHIO

Molina Healthcare
Cleveland, OH
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*****Qualified candidate must reside and be willing to travel within the ...
Details
Summary
About the job:
following Counties in OHIO: Hamilton, Butler, Warren, Clermont, Montgomery, Greene, Clark and Clinton.****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...
Location:
Cleveland, OH
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
Certified Case Manager
Certified in Long Term Care
Driver's License
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Configuration Analyst - QNXT (Benefits & Contracts)

Molina Healthcare
Columbus, OH
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**JOB DESCRIPTION****Job Summary**Responsible for accurate and timely ...
Details
Summary
About the job:
implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.**KNOWLEDGE/SKILLS/ABILITIE S**+ Analyze and interpret data...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Computer Systems Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Analyst, Business

Molina Healthcare
Dayton, OH
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**JOB DESCRIPTION****Job Summary**Analyzes complex business problems and ...
Details
Summary
About the job:
issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs. May participate in...
Location:
Dayton, OH
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Trainer - Clinical Services - Utilization Review Focus

Molina Healthcare
Ohio
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**Job Description**Job SummaryCreates and delivers clinical training ...
Details
Summary
About the job:
programs for clinical staff across the enterprise to orient employees to Molina clinical methodology, along with policies, processes and systems. Ensures all Molina clinical team members are positioned to improve quality, control medical costs, and ensure compliance with state and federal regulations and guidelines. Responsible for the development, implementation, and delivery of training curriculum for Utilization Management, Case Management, and LTSS staff. Leads and manages classes, adapting to trainee skill level,...
Location:
Ohio
Job Type:
Full-Time
Permanent
Occupation:
Training and Development Specialists
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
US.jobs
Certifications / Licenses:
Utilization Management Certification
Certified Case Manager
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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