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Specialist, Appeals & Grievances at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Appeals, Grievances, Claims Processing, Research, Resolution, Medical Records Review, Regulatory Compliance, Communication, Documentation, Time Management, Organizational Skills, Customer Service, Medicaid, Medicare, Coordination Of Benefits, Subrogation
Specialization
Candidates must possess at least two years of managed care experience in a call center, appeals, or claims environment, along with specific experience in health claims processing, including COB and subrogation. A strong understanding of Medicaid and Medicare appeals processing and regulatory guidelines is required, complemented by excellent organizational and communication skills.
Experience Required
Minimum 2 year(s)
Licensed Primary Therapist LCSW, LMFT, LPC, or LPC-MHSP at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Individual Therapy, Group Therapy, Family Therapy, Crisis Intervention, Psychosocial Assessments, Treatment Planning, Cbt, Dbt, Act, Family Systems, Addiction Counseling, Mental Health Diagnosis, Clinical Documentation, Kipu Emr, Microsoft Office, Cpr/First Aid
Specialization
Candidates must hold a Master's degree in counseling, social work, or psychology and possess an unrestricted license (LCSW, LMFT, LPC, or LPC-MHSP) in Tennessee. Experience with addictions, mental health diagnoses, and various counseling interventions like CBT and DBT is required.
Experience Required
Minimum 2 year(s)
Medical Coder at CureMD Healthcare
Lahore, Punjab, Pakistan - Full Time
Skills Needed
Medical Coding, Icd 10, Cpt, Hcpcs, Medical Terminology, Revenue Cycle Management, Data Analysis, Compliance, Billing, Documentation Review, Project Management, Communication Skills, Analytical Skills
Specialization
Candidates must hold at least a Bachelor's degree and possess 1 to 3 years of experience in US medical billing or coding. A strong understanding of revenue cycle management, reimbursement regulations, and excellent analytical skills are required.
Behavioral Health Technician Full-time 3rd Shift at Evoraa Healthcare
Madison, Tennessee, United States - Full Time
Skills Needed
Client Supervision, De Escalation, Crisis Management, Electronic Medical Records, Interpersonal Communication, Time Management, Emotional Support, Patient Safety, Detail Oriented, Professional Boundaries
Specialization
Candidates should ideally be high school graduates or have a GED, with a valid driver's license and a preference for experience in mental health or substance abuse. Essential competencies include strong communication skills, empathy, and the ability to work under pressure.
Adjudicator, Provider Claims-On the phone-closing shift at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Claims Adjudication, Provider Relations, Data Analysis, Customer Service, Research, Time Management, Microsoft Office, Written Communication, Verbal Communication, Claims Investigation, Reimbursement Methodology, Attention To Detail
Specialization
Requires at least 2 years of experience in a clerical claims or customer service role within a managed care organization. Must possess strong data analysis, organizational, and communication skills along with proficiency in Microsoft Office.
Experience Required
Minimum 2 year(s)
Senior Specialist, IRIS Operations (Must reside in WI) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Administrative Support, Data Entry, Customer Service, Project Management, Problem Solving, Time Management, Hipaa Compliance, Microsoft Office, Power Bi, Sharepoint, Analytical Skills, Written Communication, Verbal Communication, Workflow Analysis, Case Management, Eligibility Verification
Specialization
Requires a bachelor's degree or equivalent experience and at least 2 years of administrative or healthcare experience. Must possess strong organizational skills and proficiency in Microsoft Office, SharePoint, and Power BI.
Experience Required
Minimum 2 year(s)
Case Manager at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Case Management, Substance Abuse Counseling, Patient Screening, Intake Assessment, Individualized Service Planning, Psychoeducational Instruction, Motivational Enhancement, Crisis Intervention, Documentation, Community Resource Coordination, Interpersonal Skills, Analytical Skills, Customer Service, Regulatory Compliance, Time Management
Specialization
A Bachelor's degree from an accredited institution or an equivalent combination of education and experience is required. Candidates must have experience in case management, substance abuse, and mental health support services.
Experience Required
Minimum 2 year(s)
Group Facilitator Full-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Group Therapy, Crisis Intervention, Psychoeducation, Clinical Documentation, Microsoft Office, Kipu Emr, Cpr, First Aid
Specialization
A bachelor's degree in Psychology, Social Work, or Human Services is required. Candidates should have CPR/First Aid certification and preferably have experience with addictions and mental health diagnoses.
Supervisor, IRIS Consulting Services Barron WI,Rusk WI, Dunn WI and Chippew at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Leadership, Supervision, Training, Person Centered Practices, Data Analysis, Record Review, Communication, Change Management, Networking, Performance Management, Team Development, Problem Solving, Critical Thinking, Time Management, Hipaa, Microsoft Office
Specialization
Candidates must have at least 5 years in healthcare, preferably care coordination, and 2 years serving the target groups (adults with disabilities or older adults), or equivalent experience. A Bachelor's degree in a related field is required, though significant relevant experience may substitute for the degree, alongside a valid driver's license and demonstrated competencies in leadership and performance management.
Experience Required
Minimum 5 year(s)
Behavioral Health Technician 2nd Shift Full-time at Evoraa Healthcare
, Georgia, United States - Full Time
Skills Needed
Behavioral Health Support, Client Supervision, De Escalation, Documentation, Safety Monitoring, Interpersonal Skills, Time Management, Multi Tasking, Electronic Medical Records, Communication Skills, Crisis Intervention, Patient Care
Specialization
Candidates should have a high school diploma or GED and experience in substance abuse or mental health settings is preferred. A valid state driver's license with a clean driving record is required.
Manager, Projects (Customer Experience) - REMOTE at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Project Management, Process Improvement, Organizational Change Management, Operational Cadence Management, Governance Coordination, Risk Management, Issue Management, Performance Reviews, Strategic Planning, Cross Functional Coordination, Data Analysis, Dashboard Management, Execution Enablement, Managed Care, Matrixed Environment Management
Specialization
Candidates must have a bachelor's degree or equivalent experience and 4-7 years of relevant work experience in business or managed care. Proficiency in project management methodologies is required, with PMP or Six Sigma certifications being preferred.
Experience Required
Minimum 5 year(s)
Manager, Healthcare Analytics - Databricks/SQL/Python - Remote at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Databricks, Sql, Python, Ssrs, Relational Database Concepts, Sdlc, Healthcare Analytics, Team Leadership, Data Analysis, Project Management, Financial Analysis, Medical Management, Regulatory Reporting, Performance Coaching, Resource Allocation, Business Logic
Specialization
Requires a Bachelor's degree in a quantitative field and at least 10 years of experience, preferably in healthcare or claims processing. Must have 3+ years of management experience and strong proficiency in SQL and SSRS report development.
Experience Required
Minimum 10 year(s)
Respiratory Therapist at VieMed Healthcare
College Station, Texas, United States - Full Time
Skills Needed
Clinical Assessment, Patient Care, Equipment Installation, Medical Documentation, Inventory Management, Regulatory Compliance, Staff Training, Communication Skills, Financial Management, Collaboration, Presentation Skills, Customer Focus
Specialization
Requires a valid Respiratory Therapist license in the state of practice and previous medical or respiratory experience. Must be able to lift up to 50 pounds and travel to patient homes for device servicing.
Experience Required
Minimum 2 year(s)
Case Manager at Evoraa Healthcare
Madison, Tennessee, United States - Full Time
Skills Needed
Case Management, Patient Screening, Intake And Assessment, Individualized Service Planning, Psychoeducational Instruction, Motivational Enhancement, Crisis Intervention, Resource Coordination, Documentation, Substance Abuse Treatment, Mental Health Support, Interpersonal Skills, Analytical Skills, Customer Service, Regulatory Compliance, Time Management
Specialization
A Bachelor's degree from an accredited institution or an equivalent combination of education and experience is required. Candidates must have professional experience in case management, substance abuse, and mental health support services.
Experience Required
Minimum 2 year(s)
Remote Lead, Healthcare Services - Data-Driven Responsibilities - Texas ONL at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Care Management, Managed Care, Hedis Measures, Quality Improvement, Compliance, Data Extraction, Microsoft Office Suite, Microsoft Word, Microsoft Outlook, Microsoft Teams, Microsoft Excel, Clinical Support, Utilization Management, Care Transitions, Behavioral Health, Communication Skills
Specialization
Candidates must have at least 4 years of healthcare experience, including 2 years in managed care, and hold an active clinical license such as RN, LVN, LPN, LCSW, LMFT, LPCC, or LMSW. Proficiency in Microsoft Office Suite, particularly Excel, and strong communication and problem-solving skills are required.
Experience Required
Minimum 2 year(s)
Representative, Support Center III - Remote (Bilingual Preferred) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Customer Service, Call Center Operations, Problem Resolution, Data Processing, Time Management, Communication Skills, Hipaa Compliance, Microsoft Office, Salesforce, Crm, Managed Care, Insurance Knowledge, Medicaid, Medicare, Marketplace, Conflict Resolution
Specialization
Requires at least 2 years of customer service, call center, or sales experience in a high-volume environment. Candidates must have an understanding of insurance products like Medicaid and Medicare and possess strong data processing and communication skills.
Experience Required
Minimum 2 year(s)
(RN)Care Manager- Pediatric Focus (KY based) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Care Management, Care Coordination, Pediatric Care, Comprehensive Assessments, Case Management, Motivational Interviewing, Medication Reconciliation, Emr Proficiency, Hipaa Compliance, Interdisciplinary Collaboration, Time Management, Problem Solving, Critical Thinking, Written Communication, Verbal Communication, Microsoft Office
Specialization
Requires a Registered Nurse (RN) license and at least 2 years of experience in healthcare or care management. Must possess a valid driver's license and demonstrate proficiency in EMR and HIPAA regulations.
Experience Required
Minimum 2 year(s)
Group Facilitator - Part-time at Evoraa Healthcare
Norcross, Georgia, United States - Full Time
Skills Needed
Group Therapy, Crisis Intervention, Psychoeducation, Clinical Documentation, Microsoft Office, Kipu Emr, Cpr, First Aid
Specialization
A bachelor's degree in Psychology, Social Work, or Human Services is required. Experience in addictions and mental health, along with CPR/First Aid certification, is preferred.
Lead Analyst, Data - Power BI/Databricks - Remote at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Power Bi, Databricks, Data Mining, Statistical Analysis, Data Modeling, Querying, Reporting, Microsoft Excel, Data Management, Data Compilation
Specialization
Requires an Associate degree or equivalent with 5-7 years of experience, though a Bachelor's degree and 7-9 years are preferred. Must be proficient in extracting large data sets and applying quantitative methods to influence decision making.
Experience Required
Minimum 5 year(s)
Intern at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Healthcare Business, Communication, Relationship Management, Confidentiality, Hipaa Compliance, Professionalism, Time Management
Specialization
Candidates must be currently enrolled students or alumni, ranging from freshman to first-year master's level. Applicants are required to maintain confidentiality, comply with HIPAA regulations, and demonstrate the ability to build effective professional relationships.
Specialist, Appeals & Grievances at Molina Healthcare
Long Beach, California, United States -
Full Time

Start Date

Immediate

Expiry Date

24 Jun, 26

Salary

0.0

Posted On

26 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Appeals, Grievances, Claims Processing, Research, Resolution, Medical Records Review, Regulatory Compliance, Communication, Documentation, Time Management, Organizational Skills, Customer Service, Medicaid, Medicare, Coordination Of Benefits, Subrogation

Industry

Hospitals and Health Care

Description
JOB DESCRIPTION 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 standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).   Essential Job Duties • Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met. • Researches claims appeals and grievances using support systems to determine appropriate appeals and grievance outcomes.   • Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines.  • Meets claims production standards set by the department. • Applies contract language, benefits and review of covered services to claims review process.  • Contacts members/providers as needed via written and verbal communications. • Prepares appeal summaries and correspondence, and documents findings accordingly (includes information on trends as requested). • Composes all correspondence, appeals/disputes and/or grievances information concisely, accurately and in accordance with regulatory requirements.  • Researches claims processing guidelines, provider contracts, fee schedules and systems configurations, to determine root causes of payment errors.  • Resolves and prepares written response to incoming provider reconsideration requests related to claims payment, requests for claim adjustments, and/or requests from outside agencies.     Required Qualifications • At least 2 years of managed care experience in a call center, appeals, and/or claims environment, or equivalent combination of relevant education and experience. • Health claims processing experience, including coordination of benefits (COB), subrogation and eligibility criteria. • Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals and denials.  • Customer service experience.   • Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines. • Effective verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency.     Preferred Qualifications • Customer/provider experience in a managed care organization (Medicaid, Medicare, Marketplace and/or other government-sponsored program), or medical office/hospital setting. • Completion of a health care related vocational program in health care (i.e., certified coder, billing, or medical assistant).       To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Responsibilities
This role supports claims activities by reviewing and resolving member and provider complaints, disputes, and appeals, ensuring adherence to CMS standards and internal timelines. Responsibilities include researching outcomes, requesting medical records, formulating conclusions, and preparing accurate written correspondence for all resolutions.
Specialist, Appeals & Grievances at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Appeals, Grievances, Claims Processing, Research, Resolution, Medical Records Review, Regulatory Compliance, Communication, Documentation, Time Management, Organizational Skills, Customer Service, Medicaid, Medicare, Coordination Of Benefits, Subrogation
Specialization
Candidates must possess at least two years of managed care experience in a call center, appeals, or claims environment, along with specific experience in health claims processing, including COB and subrogation. A strong understanding of Medicaid and Medicare appeals processing and regulatory guidelines is required, complemented by excellent organizational and communication skills.
Experience Required
Minimum 2 year(s)
Licensed Primary Therapist LCSW, LMFT, LPC, or LPC-MHSP at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Individual Therapy, Group Therapy, Family Therapy, Crisis Intervention, Psychosocial Assessments, Treatment Planning, Cbt, Dbt, Act, Family Systems, Addiction Counseling, Mental Health Diagnosis, Clinical Documentation, Kipu Emr, Microsoft Office, Cpr/First Aid
Specialization
Candidates must hold a Master's degree in counseling, social work, or psychology and possess an unrestricted license (LCSW, LMFT, LPC, or LPC-MHSP) in Tennessee. Experience with addictions, mental health diagnoses, and various counseling interventions like CBT and DBT is required.
Experience Required
Minimum 2 year(s)
Medical Coder at CureMD Healthcare
Lahore, Punjab, Pakistan - Full Time
Skills Needed
Medical Coding, Icd 10, Cpt, Hcpcs, Medical Terminology, Revenue Cycle Management, Data Analysis, Compliance, Billing, Documentation Review, Project Management, Communication Skills, Analytical Skills
Specialization
Candidates must hold at least a Bachelor's degree and possess 1 to 3 years of experience in US medical billing or coding. A strong understanding of revenue cycle management, reimbursement regulations, and excellent analytical skills are required.
Behavioral Health Technician Full-time 3rd Shift at Evoraa Healthcare
Madison, Tennessee, United States - Full Time
Skills Needed
Client Supervision, De Escalation, Crisis Management, Electronic Medical Records, Interpersonal Communication, Time Management, Emotional Support, Patient Safety, Detail Oriented, Professional Boundaries
Specialization
Candidates should ideally be high school graduates or have a GED, with a valid driver's license and a preference for experience in mental health or substance abuse. Essential competencies include strong communication skills, empathy, and the ability to work under pressure.
Adjudicator, Provider Claims-On the phone-closing shift at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Claims Adjudication, Provider Relations, Data Analysis, Customer Service, Research, Time Management, Microsoft Office, Written Communication, Verbal Communication, Claims Investigation, Reimbursement Methodology, Attention To Detail
Specialization
Requires at least 2 years of experience in a clerical claims or customer service role within a managed care organization. Must possess strong data analysis, organizational, and communication skills along with proficiency in Microsoft Office.
Experience Required
Minimum 2 year(s)
Senior Specialist, IRIS Operations (Must reside in WI) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Administrative Support, Data Entry, Customer Service, Project Management, Problem Solving, Time Management, Hipaa Compliance, Microsoft Office, Power Bi, Sharepoint, Analytical Skills, Written Communication, Verbal Communication, Workflow Analysis, Case Management, Eligibility Verification
Specialization
Requires a bachelor's degree or equivalent experience and at least 2 years of administrative or healthcare experience. Must possess strong organizational skills and proficiency in Microsoft Office, SharePoint, and Power BI.
Experience Required
Minimum 2 year(s)
Case Manager at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Case Management, Substance Abuse Counseling, Patient Screening, Intake Assessment, Individualized Service Planning, Psychoeducational Instruction, Motivational Enhancement, Crisis Intervention, Documentation, Community Resource Coordination, Interpersonal Skills, Analytical Skills, Customer Service, Regulatory Compliance, Time Management
Specialization
A Bachelor's degree from an accredited institution or an equivalent combination of education and experience is required. Candidates must have experience in case management, substance abuse, and mental health support services.
Experience Required
Minimum 2 year(s)
Group Facilitator Full-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Group Therapy, Crisis Intervention, Psychoeducation, Clinical Documentation, Microsoft Office, Kipu Emr, Cpr, First Aid
Specialization
A bachelor's degree in Psychology, Social Work, or Human Services is required. Candidates should have CPR/First Aid certification and preferably have experience with addictions and mental health diagnoses.
Supervisor, IRIS Consulting Services Barron WI,Rusk WI, Dunn WI and Chippew at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Leadership, Supervision, Training, Person Centered Practices, Data Analysis, Record Review, Communication, Change Management, Networking, Performance Management, Team Development, Problem Solving, Critical Thinking, Time Management, Hipaa, Microsoft Office
Specialization
Candidates must have at least 5 years in healthcare, preferably care coordination, and 2 years serving the target groups (adults with disabilities or older adults), or equivalent experience. A Bachelor's degree in a related field is required, though significant relevant experience may substitute for the degree, alongside a valid driver's license and demonstrated competencies in leadership and performance management.
Experience Required
Minimum 5 year(s)
Behavioral Health Technician 2nd Shift Full-time at Evoraa Healthcare
, Georgia, United States - Full Time
Skills Needed
Behavioral Health Support, Client Supervision, De Escalation, Documentation, Safety Monitoring, Interpersonal Skills, Time Management, Multi Tasking, Electronic Medical Records, Communication Skills, Crisis Intervention, Patient Care
Specialization
Candidates should have a high school diploma or GED and experience in substance abuse or mental health settings is preferred. A valid state driver's license with a clean driving record is required.
Manager, Projects (Customer Experience) - REMOTE at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Project Management, Process Improvement, Organizational Change Management, Operational Cadence Management, Governance Coordination, Risk Management, Issue Management, Performance Reviews, Strategic Planning, Cross Functional Coordination, Data Analysis, Dashboard Management, Execution Enablement, Managed Care, Matrixed Environment Management
Specialization
Candidates must have a bachelor's degree or equivalent experience and 4-7 years of relevant work experience in business or managed care. Proficiency in project management methodologies is required, with PMP or Six Sigma certifications being preferred.
Experience Required
Minimum 5 year(s)
Manager, Healthcare Analytics - Databricks/SQL/Python - Remote at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Databricks, Sql, Python, Ssrs, Relational Database Concepts, Sdlc, Healthcare Analytics, Team Leadership, Data Analysis, Project Management, Financial Analysis, Medical Management, Regulatory Reporting, Performance Coaching, Resource Allocation, Business Logic
Specialization
Requires a Bachelor's degree in a quantitative field and at least 10 years of experience, preferably in healthcare or claims processing. Must have 3+ years of management experience and strong proficiency in SQL and SSRS report development.
Experience Required
Minimum 10 year(s)
Respiratory Therapist at VieMed Healthcare
College Station, Texas, United States - Full Time
Skills Needed
Clinical Assessment, Patient Care, Equipment Installation, Medical Documentation, Inventory Management, Regulatory Compliance, Staff Training, Communication Skills, Financial Management, Collaboration, Presentation Skills, Customer Focus
Specialization
Requires a valid Respiratory Therapist license in the state of practice and previous medical or respiratory experience. Must be able to lift up to 50 pounds and travel to patient homes for device servicing.
Experience Required
Minimum 2 year(s)
Case Manager at Evoraa Healthcare
Madison, Tennessee, United States - Full Time
Skills Needed
Case Management, Patient Screening, Intake And Assessment, Individualized Service Planning, Psychoeducational Instruction, Motivational Enhancement, Crisis Intervention, Resource Coordination, Documentation, Substance Abuse Treatment, Mental Health Support, Interpersonal Skills, Analytical Skills, Customer Service, Regulatory Compliance, Time Management
Specialization
A Bachelor's degree from an accredited institution or an equivalent combination of education and experience is required. Candidates must have professional experience in case management, substance abuse, and mental health support services.
Experience Required
Minimum 2 year(s)
Remote Lead, Healthcare Services - Data-Driven Responsibilities - Texas ONL at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Care Management, Managed Care, Hedis Measures, Quality Improvement, Compliance, Data Extraction, Microsoft Office Suite, Microsoft Word, Microsoft Outlook, Microsoft Teams, Microsoft Excel, Clinical Support, Utilization Management, Care Transitions, Behavioral Health, Communication Skills
Specialization
Candidates must have at least 4 years of healthcare experience, including 2 years in managed care, and hold an active clinical license such as RN, LVN, LPN, LCSW, LMFT, LPCC, or LMSW. Proficiency in Microsoft Office Suite, particularly Excel, and strong communication and problem-solving skills are required.
Experience Required
Minimum 2 year(s)
Representative, Support Center III - Remote (Bilingual Preferred) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Customer Service, Call Center Operations, Problem Resolution, Data Processing, Time Management, Communication Skills, Hipaa Compliance, Microsoft Office, Salesforce, Crm, Managed Care, Insurance Knowledge, Medicaid, Medicare, Marketplace, Conflict Resolution
Specialization
Requires at least 2 years of customer service, call center, or sales experience in a high-volume environment. Candidates must have an understanding of insurance products like Medicaid and Medicare and possess strong data processing and communication skills.
Experience Required
Minimum 2 year(s)
(RN)Care Manager- Pediatric Focus (KY based) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Care Management, Care Coordination, Pediatric Care, Comprehensive Assessments, Case Management, Motivational Interviewing, Medication Reconciliation, Emr Proficiency, Hipaa Compliance, Interdisciplinary Collaboration, Time Management, Problem Solving, Critical Thinking, Written Communication, Verbal Communication, Microsoft Office
Specialization
Requires a Registered Nurse (RN) license and at least 2 years of experience in healthcare or care management. Must possess a valid driver's license and demonstrate proficiency in EMR and HIPAA regulations.
Experience Required
Minimum 2 year(s)
Group Facilitator - Part-time at Evoraa Healthcare
Norcross, Georgia, United States - Full Time
Skills Needed
Group Therapy, Crisis Intervention, Psychoeducation, Clinical Documentation, Microsoft Office, Kipu Emr, Cpr, First Aid
Specialization
A bachelor's degree in Psychology, Social Work, or Human Services is required. Experience in addictions and mental health, along with CPR/First Aid certification, is preferred.
Lead Analyst, Data - Power BI/Databricks - Remote at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Power Bi, Databricks, Data Mining, Statistical Analysis, Data Modeling, Querying, Reporting, Microsoft Excel, Data Management, Data Compilation
Specialization
Requires an Associate degree or equivalent with 5-7 years of experience, though a Bachelor's degree and 7-9 years are preferred. Must be proficient in extracting large data sets and applying quantitative methods to influence decision making.
Experience Required
Minimum 5 year(s)
Intern at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Healthcare Business, Communication, Relationship Management, Confidentiality, Hipaa Compliance, Professionalism, Time Management
Specialization
Candidates must be currently enrolled students or alumni, ranging from freshman to first-year master's level. Applicants are required to maintain confidentiality, comply with HIPAA regulations, and demonstrate the ability to build effective professional relationships.