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HOPE Navigator (Social & Health Equity Navigator) Must Live In FL (Remote) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Social Determinants Of Health, Health Equity, Care Coordination, Public Health, Social Services, Critical Thinking, Interdisciplinary Care Team, Data Interpretation, Stakeholder Management, Hipaa Compliance, Communication Skills, Microsoft Office, Multitasking, Cultural Competence
Specialization
Candidates must have at least 2 years of experience in public health or social services and a strong understanding of health disparities. Proficiency in Microsoft Office and the ability to maintain HIPAA compliance are required.
Experience Required
Minimum 2 year(s)
Community Behavioral Health Liaison ( BNET Program) Must Reside in FL at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Member Advocacy, Case Management, Community Outreach, Health Care Navigation, Data Research, Customer Service, Time Management, Organizational Skills, Microsoft Office, Communication Skills, Social Services Coordination, Transition Planning
Specialization
Candidates must have at least one year of health care experience working with underserved or special needs populations. A valid driver's license, reliable transportation, and the ability to perform significant local travel are required.
Principal AI Architect - Goverance/Finance Operations - Remote at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Ai Strategy, Ai Governance, Ai Finops, Generative Ai, Machine Learning, Llmops, Modelops, Enterprise Architecture, Responsible Ai, Rag, Cloud Native Technologies, Data Modernization, Predictive Analytics, Decision Intelligence, Api Integration, Technical Leadership
Specialization
Requires a Bachelor's degree and over 10 years of experience in AI/ML system development and enterprise architecture. Deep expertise in generative AI, cloud-native technologies, and TOGAF certification is preferred.
Experience Required
Minimum 10 year(s)
Senior Clinical Pharmacist - Onc/Haem at HCA Healthcare UK
, , United Kingdom - Full Time
Skills Needed
Clinical Pharmacy, Oncology, Haematology, Bone Marrow Transplant, Car T Therapy, Cellular Therapies, Patient Counselling, Medication Preparation, Antimicrobial Review, Nutrition Review, Ward Rounds, Discharge Planning
Specialization
Requires a Master's in Clinical Pharmacy or equivalent and GPhC registration. Candidates must have at least 2 years of hospital experience in complex oncology and haematology, specifically with cellular therapies.
Experience Required
Minimum 2 year(s)
Cook Full-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Meal Preparation, Food Safety, Inventory Management, Sanitization, Nutrition Compliance, Kitchen Cleaning, Portion Control
Specialization
Candidates should preferably have a high school diploma and must hold a Food Handler Certificate. Additional requirements include a clean criminal record regarding felonies and substance abuse, and knowledge of Board of Health guidelines.
RN/LPN Full-time Nightshift at Evoraa Healthcare
, Georgia, United States - Full Time
Skills Needed
Medication Administration, Vital Signs Monitoring, Patient Assessment, Client Admissions, Patient Discharge, Hipaa Compliance, Blood Draws, Tb Testing, Psychiatric Care, Chemical Dependency Treatment, Patient Observation, Clinical Documentation
Specialization
Candidates must hold a current unrestricted RN or LPN license in Georgia. Ability to work compassionately with individuals in psychiatric care or chemical dependency recovery is required.
Program Coordinator (Must Reside in Arizona) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Administrative Support, Document Preparation, File Management, Scheduling, Travel Arrangement, Program Administration, Project Metrics Monitoring, Process Improvement, Budgeting, Statistical Reporting, Compliance Management, Liaison Communication
Specialization
Requires an associate degree or equivalent with 1-3 years of experience, though a bachelor's degree and 3-5 years are preferred. Candidates must reside in Arizona and possess skills in program coordination and regulatory compliance.
Experience Required
Minimum 2 year(s)
Medical Record Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Behavioral Health Billing, Medical Records Management, Claims Processing, Ub 04, Cms 1500, Collaboratemd, Kipu, Alleva, Monday.Com, Microsoft Office Suite, Payer Remittance, Data Collection
Specialization
Candidates must have a high school diploma or equivalent and proven interpersonal skills for interfacing with insurance companies and staff. Proficiency in Microsoft Office and experience with behavioral health billing software is required.
Experience Required
Minimum 2 year(s)
Credentialing Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Provider Enrollment, Medical Coding, Cpt, Icd 10, Behavioral Health Credentialing, Crm Management, Insurance Communication, Regulatory Compliance
Specialization
Candidates must have a minimum of 5 years of experience in provider credentialing and the behavioral health field. Working knowledge of medical coding, specifically CPT and ICD-10, is required.
Experience Required
Minimum 5 year(s)
Senior Pharmacy Technician - Patient Services at HCA Healthcare UK
, , United Kingdom - Full Time
Skills Needed
Pharmacy Operations, Medicines Management, Pharmacy Procurement, Stock Control, Medicines Distribution, Ward Top Up, Patient Services, Audit, Kpi Monitoring, Quality Improvement, Mentorship, Training, Dispensary Management
Specialization
Candidates must be a registered Pharmacy Technician with a GPhC Accredited Checking Technician qualification. Prior experience working in a hospital pharmacy setting is essential for this role.
Experience Required
Minimum 2 year(s)
Field Care Manager, LTSS (LVN) - Local Travel Required at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Licensed Vocational Nurse, Licensed Practical Nurse, Care Management, Care Coordination, Ltss, Home Visits, Waiver Enrollment, Care Planning, Behavioral Health Care, Medical Necessity Assessment, Interdisciplinary Care Team, Motivational Interviewing, Time Management, Problem Solving, Critical Thinking, Microsoft Office Suite
Specialization
Candidates must be a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) with at least two years of healthcare experience, including one year working with persons with disabilities/chronic conditions in LTSS or one year in care management. A valid and unrestricted driver's license, reliable transportation, and proficiency with Microsoft Office Suite are also required.
Experience Required
Minimum 2 year(s)
AVP, Data Management (Enterprise Clinical Data Strategy & Governance) - REM at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Clinical Data Management, Data Acquisition, Data Source Integration, Business Case Development, Change Management, Strategic Planning, Data Governance, Cross Functional Leadership, Regulatory Compliance, Data Analytics, Interpersonal Skills, Communication, Continuous Improvement, Healthcare Industry Expertise, Project Management, Critical Thinking
Specialization
A bachelor's degree in a relevant field and 10+ years of related clinical data experience are required. Preferred qualifications include a master's degree and 5+ years of management experience with a strong background in strategic planning and implementation.
Experience Required
Minimum 10 year(s)
LPN - NORTH PHOENIX/SCOTTSDALE at Haggai Healthcare
Gilbert, Arizona, United States - Full Time
Skills Needed
Home Health Care, Patient Assessment, Care Plan Implementation, Skilled Nursing, Electronic Visit Verification, Patient Documentation, Collaboration, Patient Safety, Basic Life Support
Specialization
Candidates must hold a valid LPN state license, a current fingerprint clearance card, and Basic Life Support (BLS) certification. A valid driver's license and reliable transportation are also required to perform home visits.
Field Care Manager, LTSS (RN) - Local Travel Required at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Care Management, Care Coordination, Medicaid, Managed Care, Assessment, Care Planning, Motivational Interviewing, Medication Reconciliation, Microsoft Office Suite, Outlook, Excel, Teams, Documentation, Time Management, Problem Solving, Critical Thinking
Specialization
Candidates must be a licensed Registered Nurse (RN) with at least 2 years of healthcare experience, including 1 year in care management. A valid driver's license and the ability to perform local travel for home visits are required.
Experience Required
Minimum 2 year(s)
RN/LPN Full-time PRN Dayshift at Evoraa Healthcare
, Georgia, United States - Full Time
Skills Needed
Nursing, Medication Administration, Vital Signs Monitoring, Patient Assessment, Admissions, Discharge Planning, Phlebotomy, Tb Testing, Hipaa Compliance, Patient Confidentiality, Mental Health Support, Substance Abuse Treatment, Documentation, Interdisciplinary Communication
Specialization
Candidates must hold a current, unrestricted RN or LPN license in Georgia and possess an Associate's degree in Registered Nursing. Experience working with individuals in recovery or mental health treatment is considered a plus.
Payments Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Payment Posting, Reconciliation, Insurance Payments, Eras, Eobs, Claim Denial Identification, Underpayment Identification, Vendor Coordination, Repricing Workflows, Hipaa Compliance, Data Accuracy, Ehr Systems, Billing Platforms, Critical Thinking, Problem Solving, Reporting
Specialization
Candidates need 1 to 3 years of experience in medical billing, payment posting, or healthcare revenue cycle management, preferably in behavioral health. Essential qualifications include strong attention to detail, proficiency with EHR systems and billing platforms, and familiarity with insurance reimbursement processes and third-party repricing vendors.
Lead, Core Operations at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Claims Processing, Benefit Interpretation, Provider Services, Provider Enrollment, Escalation Management, Troubleshooting, Workflow Coordination, Quality Improvement, Mentoring, Customer Service, Medicare Knowledge, Medicaid Knowledge, Marketplace Plans Knowledge, Time Management, Cross Collaborative Communication, Microsoft Office
Specialization
Requires at least 4 years of experience in healthcare operations, claims, or provider services. Must possess knowledge of Medicare, Medicaid, and Marketplace plans along with proficiency in Microsoft Office.
Experience Required
Minimum 2 year(s)
Verification Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Benefit Verification, Data Entry, Customer Service, Behavioral Health, Microsoft Office Suite, Outlook, Insurance Portals, Tracking Software, Time Management, Multitasking, Communication Skills, Interpersonal Skills, Organization, Workflow Management
Specialization
Candidates must have at least a high school diploma or equivalent and strong interpersonal skills. Proficiency in Microsoft Office and the ability to manage insurance policy information are essential for this role.
Representative, Support Center at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Customer Service, Call Center Operations, Data Processing, Time Management, Hipaa Compliance, Verbal Communication, Written Communication, Microsoft Office, Conflict Resolution, Member Eligibility, Claims Status, Rapport Building
Specialization
Requires up to 1 year of customer service or call center experience in a high-volume environment. Must be proficient in Microsoft Office and able to maintain HIPAA confidentiality.
AVP, Network Strategy & Services at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Provider Network Management, Contract Negotiation, Healthcare Operations, Reimbursement Strategies, Value Based Reimbursement, Strategic Planning, Regulatory Compliance, Project Management, Executive Presentation, Data Driven Decision Making, Stakeholder Management, Performance Management, Budgeting, Cross Functional Leadership, Network Adequacy, Managed Care
Specialization
Requires at least 10 years of healthcare experience in network management and 5 years of leadership experience. Must possess expert knowledge of reimbursement methodologies across Medicaid, Medicare, and Marketplace lines of business.
Experience Required
Minimum 10 year(s)
HOPE Navigator (Social & Health Equity Navigator) Must Live In FL (Remote) at Molina Healthcare
Long Beach, California, United States -
Full Time

Start Date

Immediate

Expiry Date

02 Aug, 26

Salary

46.81

Posted On

04 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Social determinants of health, Health equity, Care coordination, Public health, Social services, Critical thinking, Interdisciplinary care team, Data interpretation, Stakeholder management, HIPAA compliance, Communication skills, Microsoft Office, Multitasking, Cultural competence

Industry

Hospitals and Health Care

Description
JOB DESCRIPTION Job Summary Provides support for member program initiatives that address social conditions that impact health outcomes; provides education, assistance, resources and best practices to members in relation to navigating the health care system. Works collaboratively with other departments to identify population social determinants of health (SDOH) needs and works to find solutions via partnerships with community organizations and/or other agencies. Contributes to overarching strategy to provide quality and cost-effective member care.    Essential Job Duties • Works directly with members to reduce barriers and social determinants of health (SDOH) issues to improve health care access and member quality of life.  • Educates members on SDOH and assists with navigating various systems.  • Promotes awareness of how SDOH affect member health outcomes.  • Conducts SDOH assessments to determine member needs and prioritizes based on member preference.  • Participates in interdisciplinary care team (ICT) meetings.  • Identifies local and national resources to facilitate staff, business owner, and department understanding of health disparities, inequities, and social risk factors impacting members.  • Assists with coordination of SDOH related activities at the health plan.  • Works with SDOH innovation team to pilot programs to address SDOH barriers for Molina members.  • Collaborates with various departments within the health plan to implement pilot SDOH initiatives and programs.  • Collaborates with SDOH innovation team to ensure all SDOH initiatives, processes, and outputs are aligned and standardized as appropriate.  • Promotes integration of services including behavioral health care, long-term services and supports (LTSS), as well as other appropriate services.  • Coordinates partnerships with other departments to ensure seamless care for members.  • Local travel may be required (based upon state/contractual requirements).    Required Qualifications •At least 2 years experience in public health, social services or similar field, or equivalent combination of relevant education and experience. • Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • Ability to coalesce diverse entities around a common goal. • Advanced understanding of social determinants of health (SDOH), health disparities, inequities and social risk factors. • Knowledgeable about and respectful of cultural issues on an individual member level. • Strong organizational skills, ability to prioritize and multitask. • Critical thinking skills, including the ability to interpret SDOH data that informs the implementation of targeted interventions to identified populations. • Ability to build strong relationships with key internal and external stakeholders through active participation in community-based initiatives. • Ability to maintain confidentiality and Comply with Health Insurance Portability and Accountability Act (HIPAA). • Excellent verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency.   Preferred Qualifications • Licensed in social work, counseling or other related field.   #PJCorp2 #LI-AC1   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
The HOPE Navigator supports member initiatives by addressing social determinants of health and facilitating access to community resources. They collaborate with interdisciplinary teams to implement pilot programs and ensure seamless care coordination for members.
HOPE Navigator (Social & Health Equity Navigator) Must Live In FL (Remote) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Social Determinants Of Health, Health Equity, Care Coordination, Public Health, Social Services, Critical Thinking, Interdisciplinary Care Team, Data Interpretation, Stakeholder Management, Hipaa Compliance, Communication Skills, Microsoft Office, Multitasking, Cultural Competence
Specialization
Candidates must have at least 2 years of experience in public health or social services and a strong understanding of health disparities. Proficiency in Microsoft Office and the ability to maintain HIPAA compliance are required.
Experience Required
Minimum 2 year(s)
Community Behavioral Health Liaison ( BNET Program) Must Reside in FL at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Member Advocacy, Case Management, Community Outreach, Health Care Navigation, Data Research, Customer Service, Time Management, Organizational Skills, Microsoft Office, Communication Skills, Social Services Coordination, Transition Planning
Specialization
Candidates must have at least one year of health care experience working with underserved or special needs populations. A valid driver's license, reliable transportation, and the ability to perform significant local travel are required.
Principal AI Architect - Goverance/Finance Operations - Remote at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Ai Strategy, Ai Governance, Ai Finops, Generative Ai, Machine Learning, Llmops, Modelops, Enterprise Architecture, Responsible Ai, Rag, Cloud Native Technologies, Data Modernization, Predictive Analytics, Decision Intelligence, Api Integration, Technical Leadership
Specialization
Requires a Bachelor's degree and over 10 years of experience in AI/ML system development and enterprise architecture. Deep expertise in generative AI, cloud-native technologies, and TOGAF certification is preferred.
Experience Required
Minimum 10 year(s)
Senior Clinical Pharmacist - Onc/Haem at HCA Healthcare UK
, , United Kingdom - Full Time
Skills Needed
Clinical Pharmacy, Oncology, Haematology, Bone Marrow Transplant, Car T Therapy, Cellular Therapies, Patient Counselling, Medication Preparation, Antimicrobial Review, Nutrition Review, Ward Rounds, Discharge Planning
Specialization
Requires a Master's in Clinical Pharmacy or equivalent and GPhC registration. Candidates must have at least 2 years of hospital experience in complex oncology and haematology, specifically with cellular therapies.
Experience Required
Minimum 2 year(s)
Cook Full-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Meal Preparation, Food Safety, Inventory Management, Sanitization, Nutrition Compliance, Kitchen Cleaning, Portion Control
Specialization
Candidates should preferably have a high school diploma and must hold a Food Handler Certificate. Additional requirements include a clean criminal record regarding felonies and substance abuse, and knowledge of Board of Health guidelines.
RN/LPN Full-time Nightshift at Evoraa Healthcare
, Georgia, United States - Full Time
Skills Needed
Medication Administration, Vital Signs Monitoring, Patient Assessment, Client Admissions, Patient Discharge, Hipaa Compliance, Blood Draws, Tb Testing, Psychiatric Care, Chemical Dependency Treatment, Patient Observation, Clinical Documentation
Specialization
Candidates must hold a current unrestricted RN or LPN license in Georgia. Ability to work compassionately with individuals in psychiatric care or chemical dependency recovery is required.
Program Coordinator (Must Reside in Arizona) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Administrative Support, Document Preparation, File Management, Scheduling, Travel Arrangement, Program Administration, Project Metrics Monitoring, Process Improvement, Budgeting, Statistical Reporting, Compliance Management, Liaison Communication
Specialization
Requires an associate degree or equivalent with 1-3 years of experience, though a bachelor's degree and 3-5 years are preferred. Candidates must reside in Arizona and possess skills in program coordination and regulatory compliance.
Experience Required
Minimum 2 year(s)
Medical Record Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Behavioral Health Billing, Medical Records Management, Claims Processing, Ub 04, Cms 1500, Collaboratemd, Kipu, Alleva, Monday.Com, Microsoft Office Suite, Payer Remittance, Data Collection
Specialization
Candidates must have a high school diploma or equivalent and proven interpersonal skills for interfacing with insurance companies and staff. Proficiency in Microsoft Office and experience with behavioral health billing software is required.
Experience Required
Minimum 2 year(s)
Credentialing Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Provider Enrollment, Medical Coding, Cpt, Icd 10, Behavioral Health Credentialing, Crm Management, Insurance Communication, Regulatory Compliance
Specialization
Candidates must have a minimum of 5 years of experience in provider credentialing and the behavioral health field. Working knowledge of medical coding, specifically CPT and ICD-10, is required.
Experience Required
Minimum 5 year(s)
Senior Pharmacy Technician - Patient Services at HCA Healthcare UK
, , United Kingdom - Full Time
Skills Needed
Pharmacy Operations, Medicines Management, Pharmacy Procurement, Stock Control, Medicines Distribution, Ward Top Up, Patient Services, Audit, Kpi Monitoring, Quality Improvement, Mentorship, Training, Dispensary Management
Specialization
Candidates must be a registered Pharmacy Technician with a GPhC Accredited Checking Technician qualification. Prior experience working in a hospital pharmacy setting is essential for this role.
Experience Required
Minimum 2 year(s)
Field Care Manager, LTSS (LVN) - Local Travel Required at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Licensed Vocational Nurse, Licensed Practical Nurse, Care Management, Care Coordination, Ltss, Home Visits, Waiver Enrollment, Care Planning, Behavioral Health Care, Medical Necessity Assessment, Interdisciplinary Care Team, Motivational Interviewing, Time Management, Problem Solving, Critical Thinking, Microsoft Office Suite
Specialization
Candidates must be a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) with at least two years of healthcare experience, including one year working with persons with disabilities/chronic conditions in LTSS or one year in care management. A valid and unrestricted driver's license, reliable transportation, and proficiency with Microsoft Office Suite are also required.
Experience Required
Minimum 2 year(s)
AVP, Data Management (Enterprise Clinical Data Strategy & Governance) - REM at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Clinical Data Management, Data Acquisition, Data Source Integration, Business Case Development, Change Management, Strategic Planning, Data Governance, Cross Functional Leadership, Regulatory Compliance, Data Analytics, Interpersonal Skills, Communication, Continuous Improvement, Healthcare Industry Expertise, Project Management, Critical Thinking
Specialization
A bachelor's degree in a relevant field and 10+ years of related clinical data experience are required. Preferred qualifications include a master's degree and 5+ years of management experience with a strong background in strategic planning and implementation.
Experience Required
Minimum 10 year(s)
LPN - NORTH PHOENIX/SCOTTSDALE at Haggai Healthcare
Gilbert, Arizona, United States - Full Time
Skills Needed
Home Health Care, Patient Assessment, Care Plan Implementation, Skilled Nursing, Electronic Visit Verification, Patient Documentation, Collaboration, Patient Safety, Basic Life Support
Specialization
Candidates must hold a valid LPN state license, a current fingerprint clearance card, and Basic Life Support (BLS) certification. A valid driver's license and reliable transportation are also required to perform home visits.
Field Care Manager, LTSS (RN) - Local Travel Required at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Care Management, Care Coordination, Medicaid, Managed Care, Assessment, Care Planning, Motivational Interviewing, Medication Reconciliation, Microsoft Office Suite, Outlook, Excel, Teams, Documentation, Time Management, Problem Solving, Critical Thinking
Specialization
Candidates must be a licensed Registered Nurse (RN) with at least 2 years of healthcare experience, including 1 year in care management. A valid driver's license and the ability to perform local travel for home visits are required.
Experience Required
Minimum 2 year(s)
RN/LPN Full-time PRN Dayshift at Evoraa Healthcare
, Georgia, United States - Full Time
Skills Needed
Nursing, Medication Administration, Vital Signs Monitoring, Patient Assessment, Admissions, Discharge Planning, Phlebotomy, Tb Testing, Hipaa Compliance, Patient Confidentiality, Mental Health Support, Substance Abuse Treatment, Documentation, Interdisciplinary Communication
Specialization
Candidates must hold a current, unrestricted RN or LPN license in Georgia and possess an Associate's degree in Registered Nursing. Experience working with individuals in recovery or mental health treatment is considered a plus.
Payments Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Payment Posting, Reconciliation, Insurance Payments, Eras, Eobs, Claim Denial Identification, Underpayment Identification, Vendor Coordination, Repricing Workflows, Hipaa Compliance, Data Accuracy, Ehr Systems, Billing Platforms, Critical Thinking, Problem Solving, Reporting
Specialization
Candidates need 1 to 3 years of experience in medical billing, payment posting, or healthcare revenue cycle management, preferably in behavioral health. Essential qualifications include strong attention to detail, proficiency with EHR systems and billing platforms, and familiarity with insurance reimbursement processes and third-party repricing vendors.
Lead, Core Operations at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Claims Processing, Benefit Interpretation, Provider Services, Provider Enrollment, Escalation Management, Troubleshooting, Workflow Coordination, Quality Improvement, Mentoring, Customer Service, Medicare Knowledge, Medicaid Knowledge, Marketplace Plans Knowledge, Time Management, Cross Collaborative Communication, Microsoft Office
Specialization
Requires at least 4 years of experience in healthcare operations, claims, or provider services. Must possess knowledge of Medicare, Medicaid, and Marketplace plans along with proficiency in Microsoft Office.
Experience Required
Minimum 2 year(s)
Verification Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Benefit Verification, Data Entry, Customer Service, Behavioral Health, Microsoft Office Suite, Outlook, Insurance Portals, Tracking Software, Time Management, Multitasking, Communication Skills, Interpersonal Skills, Organization, Workflow Management
Specialization
Candidates must have at least a high school diploma or equivalent and strong interpersonal skills. Proficiency in Microsoft Office and the ability to manage insurance policy information are essential for this role.
Representative, Support Center at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Customer Service, Call Center Operations, Data Processing, Time Management, Hipaa Compliance, Verbal Communication, Written Communication, Microsoft Office, Conflict Resolution, Member Eligibility, Claims Status, Rapport Building
Specialization
Requires up to 1 year of customer service or call center experience in a high-volume environment. Must be proficient in Microsoft Office and able to maintain HIPAA confidentiality.
AVP, Network Strategy & Services at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Provider Network Management, Contract Negotiation, Healthcare Operations, Reimbursement Strategies, Value Based Reimbursement, Strategic Planning, Regulatory Compliance, Project Management, Executive Presentation, Data Driven Decision Making, Stakeholder Management, Performance Management, Budgeting, Cross Functional Leadership, Network Adequacy, Managed Care
Specialization
Requires at least 10 years of healthcare experience in network management and 5 years of leadership experience. Must possess expert knowledge of reimbursement methodologies across Medicaid, Medicare, and Marketplace lines of business.
Experience Required
Minimum 10 year(s)