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Community Connector - Onsite - (Clark County)

Molina Healthcare
Columbus, OH
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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**+ Serves as a community based member advocate and resource,...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Social and Human Service Assistants
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
4
apply
Detailed Job Information

Director, Medicare Product Development

Molina Healthcare
Located in Ohio
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Job Ref: 300001036756823 Employer: Molina Healthcare Sector: Health ...
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Summary
About the job:
Insurance Qualifications: Senior Qualified Actuary Job Type: Full Time Salary and Benefits: Competitive Remote: Yes Location Country: United States State/Province/County: California - CA City: Long Beach Post Code: 90802 Map: ( Show on map ) Description Job Description JOB DESCRIPTION Job Summary This position is responsible for supporting development and pricing of Medicare products, which include MA-PD, D-SNP and MMP. KNOWLEDGE/SKILLS/ABILITIES The Director Medicare Product Development is a key member of a small team that...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Marketing Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
7
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Director, Medicare Product Development

Molina Healthcare
Located in Ohio
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Job Ref: 2025414 Employer: Molina Healthcare Sector: Health Insurance ...
Details
Summary
About the job:
Qualifications: Senior Qualified Actuary Job Type: Full Time Salary and Benefits: $87,568 - $189,732 per year Remote: No Location Country: United States Post Code: Not specified Map: ( Show on map ) Description JOB DESCRIPTION Job Summary This position is responsible for supporting development and pricing of Medicare products, which include MA-PD, D-SNP and MMP. KNOWLEDGE/SKILLS/ABILITIES The Director Medicare Product Development is a key member of a small team that is responsible for significantly contributing to Medicare...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Marketing Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
7
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

VP, Marketplace Network Strategy and Services

Molina Healthcare
Located in Ohio
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JOB DESCRIPTION Job Summary Molina Provider Network Management and ...
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Summary
About the job:
Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Analyst, Config Info Mgmt - NetworX/QNXT - Remote

Molina Healthcare
Located in Ohio
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JOB DESCRIPTION Job Summary Responsible for accurate and timely ...
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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/ABILITIES - Analyze and interpret data to...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Computer Network Architects
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
4
apply
Detailed Job Information

Sr Analyst, Quality Interventions/QI Compliance (Remote in Arizona)

Molina Healthcare
Located in Ohio
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JOB DESCRIPTION Job Summary Molina's Quality Improvement function oversees, ...
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Summary
About the job:
plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. To proceed in the process candidates need experience in healthcare analytics, quality metric reporting and...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Certified HEDIS Compliance Auditor
National Committee for Quality Assurance
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
4
apply
Detailed Job Information

Sr Actuarial Analyst - Remote

Molina Healthcare
Located in Ohio
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Job Ref: 300001027999305 Employer: Molina Healthcare Sector: Health ...
Details
Summary
About the job:
Insurance Qualifications: Part Qualified Actuary Job Type: Full Time Salary and Benefits: Competitive Remote: Yes Location Country: United States State/Province/County: California - CA City: Long Beach Post Code: 90802 Map: ( Show on map ) Description Job Description JOB DESCRIPTION Job Summary Responsible for estimating liabilities, establishing premium rates, financial analysis, and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. KNOWLEDGE/SKILLS/ABILITIES - Collaborate with...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Actuaries
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Associate of the Society of Actuaries
Actuarial Exams
Workkeys
Applied Math
7
Graphic Literacy
6
Workplace Documents
7
apply
Detailed Job Information

Associate Actuarial Analyst - New Grad (REMOTE)

Molina Healthcare
Located in Ohio
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Job Ref: 300001045145389 Employer: Molina Healthcare Sector: Health ...
Details
Summary
About the job:
Insurance Qualifications: Graduate Actuary Job Type: Full Time Salary and Benefits: Competitive Remote: No Location Country: United States State/Province/County: California - CA City: Long Beach Post Code: 90802 Map: ( Show on map ) Description Job Description JOB DESCRIPTION Job Summary Responsible for estimating liabilities, establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. KNOWLEDGE/SKILLS/ABILITIES - Support the development of the...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Actuaries
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Actuarial Exams
Workkeys
Applied Math
7
Graphic Literacy
6
Workplace Documents
7
apply
Detailed Job Information

Associate Actuarial Analyst - New Grad

Molina Healthcare
Located in Ohio
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JOB DESCRIPTION Job Summary Responsible for estimating liabilities, ...
Details
Summary
About the job:
establishing premium rates, financial analysis and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. KNOWLEDGE/SKILLS/ABILITIES - Support the development of the IBNR estimates and rate adequacy studies. Document assumptions. - Analyze results to identify early signs of trends or other issues related to medical care costs. - Perform actuarial studies related to medical care costs and trends. - Generate and distribute routine reports to support IBNR calculations, pricing, and financial...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Actuaries
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Actuarial Exams
Workkeys
Applied Math
7
Graphic Literacy
6
Workplace Documents
7
apply
Detailed Job Information

Rep, Pharmacy - Remote

Molina Healthcare
Located in Ohio
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JOB DESCRIPTION Job Summary Molina Pharmacy Services/Management staff work ...
Details
Summary
About the job:
to ensure that Molina members, providers, and pharmacies have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Pharmacy Technicians
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
Certifications / Licenses:
National Pharmacy Technician
National Committee for Quality Assurance
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
4
apply
Detailed Job Information
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