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Systems Administrator, Provider Network

Molina Healthcare
Warren, MI
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Job Description Job Summary Provider Network Business Systems Administrator ...
Details
Summary
About the job:
will work to help businesses improve efficiencies by using computer systems. It involves programming, networking, database management i.e. Salesforce, Conga Contract Lifecycle Management, Virsys 12 or other provider network administration applications as applicable. This role will require a comprehensive knowledge of computer information systems along with the skills necessary for effective decision making in a business environment that is diverse and highly competitive. The Provider Network Business Systems...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Network and Computer Systems Administrators
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
State of Michigan
Certifications / Licenses:
Salesforce.com certified
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Analyst, Healthcare Analytics (Risk Adjustment) - REMOTE

Molina Healthcare
Warren, MI
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JOB DESCRIPTION Job Summary This Sr. Analyst, Healthcare Analytics role will ...
Details
Summary
About the job:
be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare intervention program performance. Develops and presents Risk Adjustment intervention ROI, incremental conditions captured, and other program performance reports including forecasts and makes recommendations based on relevant findings. Performs Health...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Business Intelligence Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
State of Michigan
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Review Clinician, PA (RN) Transplants

Molina Healthcare
Warren, MI
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*California Residents preferred JOB DESCRIPTION Job Summary Molina ...
Details
Summary
About the job:
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 cost-effective based on the severity of illness and the site of service. KNOWLEDGE/SKILLS/ABILITIES - Assesses services for members to...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
State of Michigan
Certifications / Licenses:
Certified Registered Nurse
Certified in Long Term Care
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Associate Program Manager

Molina Healthcare
Warren, MI
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Job Description Job Summary Responsible for internal business projects and ...
Details
Summary
About the job:
programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/program management, rather than the application of expertise in a specialized functional field of knowledge...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Middle Income Jobs ($30K-$49K)
From:
State of Michigan
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Review Clinician, PA (RN)

Molina Healthcare
Warren, MI
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JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with ...
Details
Summary
About the job:
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 - Assesses services for members to ensure optimum outcomes, cost...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
State of Michigan
Certifications / Licenses:
Certified Registered Nurse
Certified in Long Term Care
Certified Professional In Healthcare Management
Utilization Management Certification
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Lead Engineer, EIS - Azure Cloud/Commvault/Storage - Remote

Molina Healthcare
Warren, MI
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JOB DESCRIPTION Job Summary Builds company specific systems and technology ...
Details
Summary
About the job:
expertise across multiple infrastructure and development disciplines KNOWLEDGE/SKILLS/ABILITIES - Provides expertise on systems technologies and scripting languages. - Responsible for support troubleshooting and incident resolution. - Contributes to on-call rotation schedules and off-hour support activities. - Responsible for tactical build and configuration activities. - Responsible for aligning systems implementations with licensing and design requirements. - Responsible for alignment with project methodologies and...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Computer Systems Engineers/Architects
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
State of Michigan
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Director, Process Improvement & Operational Excellence

Molina Healthcare
Warren, MI
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Job Description Job Summary Leads business process improvement initiatives ...
Details
Summary
About the job:
that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of MHI's business process improvement methodology and in the implementation of a business process improvement capability. Knowledge/Skills/Abilities - Defines program scope, establish approach for implementation and maintains program infrastructure - Develop a method for assessing program effectiveness and a cadence for assessing and adjusting - Develop approach for communication organizationally about the...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
State of Michigan
Certifications / Licenses:
Six Sigma Black Belt - LEAN
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Specialist, Provider Network Administration

Molina Healthcare
Warren, MI
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JOB DESCRIPTION Job Summary Provider Network Administration is responsible ...
Details
Summary
About the job:
for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. KNOWLEDGE/SKILLS/ABILITIES - Generates and prepares provider-related data and reports in support of Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry Research & Resolution,...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Network and Computer Systems Administrators
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
State of Michigan
Certifications / Licenses:
ICD-10 / ICD-9
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Abstractor, HEDIS /Quality Improvement (Remote)

Molina Healthcare
Warren, MI
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Job Description Job Summary Molina's Quality Improvement Abstraction team ...
Details
Summary
About the job:
functions to conduct data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction team will meet chart abstraction productivity standards as well as minimum over read standards. Job Duties - Coordinates the HEDIS medical record review which includes ongoing review of records submitted by providers and the annual HEDIS medical record review. - Participates in meetings with vendors for the medical record collection process. - As needed, may...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Medical Records Specialists
Career Level / Education:
Postsecondary nondegree award
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
State of Michigan
Certifications / Licenses:
Certified Registered Nurse
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Program Manager - Network Solutions & Operations

Molina Healthcare
Warren, MI
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JOB DESCRIPTION Job Summary Responsible for internal business projects and ...
Details
Summary
About the job:
programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs, and monitors system analysis and program staff. These positions' primary focus is project/program management, rather than the application of expertise in a specialized functional field of knowledge...
Location:
Warren, MI
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
State of Michigan
Certifications / Licenses:
ITIL Certifications
Project Management Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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