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Health Plan Provider Contracts Manager - Complex at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Contract Negotiation, Value Based Payment, Provider Relationship Management, Network Adequacy, Financial Analysis, Regulatory Compliance, Managed Care, Medical Cost Ratio Analysis, Strategic Planning, Stakeholder Management, Microsoft Excel, Reimbursement Modeling
Specialization
Requires at least 5 years of network contracting experience and 3 years of managed health care negotiations. Must be proficient in various compensation methodologies including VBP, FFS, and capitation across Medicaid and Medicare lines.
Experience Required
Minimum 5 year(s)
Behavioral Health Technician 3rd Shift Full-time at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Behavioral Health Support, Client Supervision, De Escalation, Safety Monitoring, Documentation, Electronic Medical Records, Interpersonal Skills, Time Management, Multi Tasking, Communication Skills, Crisis Management, Patient Care, Record Keeping, Professional Judgment, Privacy Compliance
Specialization
Candidates should have a high school diploma or GED, with experience in substance abuse or mental health settings preferred. A valid state driver's license with no major violations in the past five years is required.
Behavioral Health Technician 2nd Shift Full-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Client Supervision, De Escalation, Crisis Management, Emotional Support, Electronic Medical Records, Interpersonal Communication, Time Management, Detail Oriented, Professional Boundaries, Patient Safety
Specialization
A high school diploma or GED is preferred, along with a valid driver's license and a clean driving record. Experience in substance abuse or mental health settings is preferred.
Behavioral Health Technician 1st Shift Full-time at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Behavioral Health Support, Client Safety Monitoring, De Escalation, Documentation, Inventory Management, Interpersonal Skills, Time Management, Multi Tasking, Electronic Medical Records, Crisis Intervention, Communication, Professional Judgment, Trauma Informed Care, Confidentiality, Team Collaboration
Specialization
Candidates should ideally possess a high school diploma or GED and have prior experience in substance abuse or mental health settings. A valid state driver's license with a clean driving record is required, along with strong communication and interpersonal skills.
Full-time Behavioral Health Technician 1st Shift at Evoraa Healthcare
Madison, Tennessee, United States - Full Time
Skills Needed
De Escalation, Client Supervision, Crisis Management, Electronic Medical Records, Interpersonal Communication, Time Management, Emotional Support, Detail Oriented, Professional Judgment, Patient Monitoring
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. Strong communication skills and the ability to remain empathetic and non-judgmental are essential.
Field Patient Care Specialist (Okanogan, WA) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Clinical Care, Phlebotomy, Patient Education, Vital Signs Collection, Hipaa Compliance, Electronic Health Records, Infection Control, Cpr, Cultural Competence, Medical Documentation, Patient Assessment, Care Coordination
Specialization
Requires an active license or certification as an MA, CNA, LVN/LPN, or Phlebotomist, along with a valid driver's license and CPR certification. Candidates must be proficient in clinical tasks and comfortable using technology for documentation and scheduling.
Experience Required
Minimum 2 year(s)
Verification Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Benefit Verification, Customer Service, Behavioral Health, Data Entry, Microsoft Office Suite, Outlook, Insurance Portals, Monday.Com, Onedrive, Time Management, Multitasking, Written Communication, Verbal Communication, Interpersonal Skills, Organization
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 the ability to follow standard operating procedures is required.
Cook Part-time at Evoraa Healthcare
Madison, Tennessee, United States - Full Time
Skills Needed
Meal Preparation, Food Safety, Inventory Management, Sanitization, Nutrition Compliance, Kitchen Cleaning
Specialization
Candidates should preferably have a high school diploma and must possess a Food Handler Certificate. Additional requirements include a clean criminal record regarding felonies and substance abuse within the last five years.
RN/LPN Part-time Nightshift at Evoraa Healthcare
Brentwood, Tennessee, 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 Care, Patient Observation, Clinical Documentation
Specialization
Candidates must hold a current unrestricted RN or LPN license in Tennessee. Ability to work compassionately with individuals in psychiatric care or chemical dependency is required.
VP, National Quality Data Management & Performance at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Quality Data Management, Hedis Operations, Performance Outcomes Management, Managed Care, Strategic Leadership, Budget Management, Change Management, Data Analysis, Executive Presence, Cross Functional Leadership, Regulatory Compliance, Vendor Management, Clinical Data Acquisition, Risk Adjustment, Stakeholder Management, Microsoft Office
Specialization
Requires at least 12 years of experience in quality data management and HEDIS operations, including 8 years in managed care and 7 years in leadership. Must possess strong business acumen, executive presence, and a proven ability to lead complex projects in a matrixed environment.
Experience Required
Minimum 10 year(s)
RN/LPN PRN Nightshift at Evoraa Healthcare
Brentwood, Tennessee, 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
Requires a current unrestricted RN or LPN license in the state of Tennessee. Candidates must be able to work compassionately with individuals in psychiatric care and those with chemical dependencies.
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.
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)
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)
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.
Enrollment Representative - Intake at Orsini Healthcare
Elk Grove Village, Illinois, United States - Full Time
Skills Needed
Pharmacy Data Entry, Pharmacy Claims Processing, Insurance Eligibility Verification, Medical Insurance Knowledge, Multitasking, Written Communication, Verbal Communication, Attention To Detail, Typing Speed (40 Wpm)
Specialization
Requires over one year of experience in pharmacy data entry and claims resolution, along with a Pharmacy Technician License. Candidates must possess strong communication skills and the ability to type 40 WPM with accuracy.
RN/LPN PRN 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 Care
Specialization
Candidates must hold a current unrestricted nursing license in Georgia. Experience in mental health or chemical dependency treatment is preferred, along with the ability to communicate effectively and compassionately.
LPN PRN Nights at Evoraa Healthcare
Madison, Tennessee, 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 Care, Patient Confidentiality, Clinical Documentation
Specialization
Candidates must hold a current unrestricted LPN license in Tennessee. Ability to work compassionately with individuals in mental health or chemical dependency treatment is required.
Senior Examiner, Claims at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Claims Examination, Claims Adjudication, Medical Coding, Fraud Detection, Case Management, Regulatory Compliance, Data Entry, Time Management, Customer Service, Microsoft Office Suite, Written Communication, Verbal Communication
Specialization
Requires at least 2 years of experience in claims or clerical customer service, preferably within a managed care setting. Proficiency in Microsoft Office and strong organizational and communication skills are essential.
Experience Required
Minimum 2 year(s)
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)
Health Plan Provider Contracts Manager - Complex at Molina Healthcare
Long Beach, California, United States -
Full Time

Start Date

Immediate

Expiry Date

04 Aug, 26

Salary

0.0

Posted On

06 May, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Contract Negotiation, Value-Based Payment, Provider Relationship Management, Network Adequacy, Financial Analysis, Regulatory Compliance, Managed Care, Medical Cost Ratio Analysis, Strategic Planning, Stakeholder Management, Microsoft Excel, Reimbursement Modeling

Industry

Hospitals and Health Care

Description
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for health plan provider network complex contracting activities.  Supports network strategy and development with respect to adequacy, financial performance and operational performance.  Responsible for negotiating agreements, including value-based payment methodology, with complex provider groups that are strategically critical to plan success, including but not limited to:  hospitals, independent physician associations (IPAs), and behavioral health organizations.   Essential Job Duties • Negotiates contracts and letters of agreement with the complex provider community to secure high quality, cost-effective and marketable plan providers.  • Contracts/re-contracts with large-scale entities involving custom reimbursement; executes standardized alternative payment model (APM) contracts; issues escalations, and supports network adequacy, joint operating committees (JOCs), and delegation oversight.  • Execution, management, and optimization of value-based contracts and enhanced provider relationship management. • Directs analysis of financial impact of deal terms and prepare details and justification for executive approval for agreements outside of Molina approval guidelines. • In conjunction with contracting leadership, negotiates complex provider contracts including high-priority physician group and facility contracts using preferred, acceptable, discouraged, unacceptable (PADU) guidelines (emphasis on number or percentage of membership in value-based relationship contracts). • Develops and maintains provider contracts in contract management software. • Targets and recruits additional providers to reduce member access grievances. • Engages targeted contracted providers in renegotiation of rates and/or language; assists with cost-control strategies that positively impact the medical cost ratio (MCR) within each region. • Advises network contracting team members on negotiation of individual provider and routine ancillary contracts. • Maintains contractual relationships with significant/highly visible providers. • Evaluates provider network and implement strategic plans with the goal of meeting Molina’s network adequacy standards. • Assesses contract language for compliance with corporate standards and regulatory requirements and review revised language with assigned corporate attorney. • Participates in fee schedule determinations including development of new reimbursement models; seeks input on new reimbursement models from corporate network leadership, legal and senior level engagement as required. • Educates internal customers on provider contracts. • Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.  • Participates with the leadership team and other committees to address the strategic goals of the department and organization. • Participates in contracting-related special projects as directed. • Provides training, mentoring and support to new and existing contracting team members.   • Ad hoc travel throughout NE, primarily Omaha:   Approximately 1-3 times per year.   Required Qualifications • At least 5 years of  experience in network contracting with large specialty or multispecialty provider groups, and at least 3 years experience in provider contract negotiations in a managed health care setting ideally negotiating different provider contract types (i.e. physician/group/hospital), or equivalent combination of relevant education and experience. • Working familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to: value-based payment (VBP), fee-for service (FFS), capitation and various forms of risk, etc. • Negotiation and relationship building capabilities. • Ability to navigate complex regulatory environments. • Data-driven decision-making skills, and analytical abilities. • Organizational skills and attention to detail. • Ability to work cross-functionally with internal/external stakeholders in a highly matrixed organization. • Ability to manage multiple tasks and deadlines effectively. • Effective verbal and written communication skills.   • Microsoft Office suite and applicable software programs proficiency.   Preferred Qualifications • Contracting experience with integrated delivery systems, hospitals and groups (specialty and ancillary). • Experience with Medicaid, Medicare, and Marketplace government-sponsored programs. MS Excel (Pivot tables and VLookup)     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
Lead complex contracting activities with hospitals and physician groups to ensure network adequacy and financial performance. Negotiate value-based payment methodologies and manage strategic provider relationships to optimize cost-effectiveness.
Health Plan Provider Contracts Manager - Complex at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Contract Negotiation, Value Based Payment, Provider Relationship Management, Network Adequacy, Financial Analysis, Regulatory Compliance, Managed Care, Medical Cost Ratio Analysis, Strategic Planning, Stakeholder Management, Microsoft Excel, Reimbursement Modeling
Specialization
Requires at least 5 years of network contracting experience and 3 years of managed health care negotiations. Must be proficient in various compensation methodologies including VBP, FFS, and capitation across Medicaid and Medicare lines.
Experience Required
Minimum 5 year(s)
Behavioral Health Technician 3rd Shift Full-time at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Behavioral Health Support, Client Supervision, De Escalation, Safety Monitoring, Documentation, Electronic Medical Records, Interpersonal Skills, Time Management, Multi Tasking, Communication Skills, Crisis Management, Patient Care, Record Keeping, Professional Judgment, Privacy Compliance
Specialization
Candidates should have a high school diploma or GED, with experience in substance abuse or mental health settings preferred. A valid state driver's license with no major violations in the past five years is required.
Behavioral Health Technician 2nd Shift Full-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Client Supervision, De Escalation, Crisis Management, Emotional Support, Electronic Medical Records, Interpersonal Communication, Time Management, Detail Oriented, Professional Boundaries, Patient Safety
Specialization
A high school diploma or GED is preferred, along with a valid driver's license and a clean driving record. Experience in substance abuse or mental health settings is preferred.
Behavioral Health Technician 1st Shift Full-time at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Behavioral Health Support, Client Safety Monitoring, De Escalation, Documentation, Inventory Management, Interpersonal Skills, Time Management, Multi Tasking, Electronic Medical Records, Crisis Intervention, Communication, Professional Judgment, Trauma Informed Care, Confidentiality, Team Collaboration
Specialization
Candidates should ideally possess a high school diploma or GED and have prior experience in substance abuse or mental health settings. A valid state driver's license with a clean driving record is required, along with strong communication and interpersonal skills.
Full-time Behavioral Health Technician 1st Shift at Evoraa Healthcare
Madison, Tennessee, United States - Full Time
Skills Needed
De Escalation, Client Supervision, Crisis Management, Electronic Medical Records, Interpersonal Communication, Time Management, Emotional Support, Detail Oriented, Professional Judgment, Patient Monitoring
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. Strong communication skills and the ability to remain empathetic and non-judgmental are essential.
Field Patient Care Specialist (Okanogan, WA) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Clinical Care, Phlebotomy, Patient Education, Vital Signs Collection, Hipaa Compliance, Electronic Health Records, Infection Control, Cpr, Cultural Competence, Medical Documentation, Patient Assessment, Care Coordination
Specialization
Requires an active license or certification as an MA, CNA, LVN/LPN, or Phlebotomist, along with a valid driver's license and CPR certification. Candidates must be proficient in clinical tasks and comfortable using technology for documentation and scheduling.
Experience Required
Minimum 2 year(s)
Verification Specialist at Evoraa Healthcare
Peachtree City, Georgia, United States - Full Time
Skills Needed
Benefit Verification, Customer Service, Behavioral Health, Data Entry, Microsoft Office Suite, Outlook, Insurance Portals, Monday.Com, Onedrive, Time Management, Multitasking, Written Communication, Verbal Communication, Interpersonal Skills, Organization
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 the ability to follow standard operating procedures is required.
Cook Part-time at Evoraa Healthcare
Madison, Tennessee, United States - Full Time
Skills Needed
Meal Preparation, Food Safety, Inventory Management, Sanitization, Nutrition Compliance, Kitchen Cleaning
Specialization
Candidates should preferably have a high school diploma and must possess a Food Handler Certificate. Additional requirements include a clean criminal record regarding felonies and substance abuse within the last five years.
RN/LPN Part-time Nightshift at Evoraa Healthcare
Brentwood, Tennessee, 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 Care, Patient Observation, Clinical Documentation
Specialization
Candidates must hold a current unrestricted RN or LPN license in Tennessee. Ability to work compassionately with individuals in psychiatric care or chemical dependency is required.
VP, National Quality Data Management & Performance at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Quality Data Management, Hedis Operations, Performance Outcomes Management, Managed Care, Strategic Leadership, Budget Management, Change Management, Data Analysis, Executive Presence, Cross Functional Leadership, Regulatory Compliance, Vendor Management, Clinical Data Acquisition, Risk Adjustment, Stakeholder Management, Microsoft Office
Specialization
Requires at least 12 years of experience in quality data management and HEDIS operations, including 8 years in managed care and 7 years in leadership. Must possess strong business acumen, executive presence, and a proven ability to lead complex projects in a matrixed environment.
Experience Required
Minimum 10 year(s)
RN/LPN PRN Nightshift at Evoraa Healthcare
Brentwood, Tennessee, 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
Requires a current unrestricted RN or LPN license in the state of Tennessee. Candidates must be able to work compassionately with individuals in psychiatric care and those with chemical dependencies.
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.
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)
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)
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.
Enrollment Representative - Intake at Orsini Healthcare
Elk Grove Village, Illinois, United States - Full Time
Skills Needed
Pharmacy Data Entry, Pharmacy Claims Processing, Insurance Eligibility Verification, Medical Insurance Knowledge, Multitasking, Written Communication, Verbal Communication, Attention To Detail, Typing Speed (40 Wpm)
Specialization
Requires over one year of experience in pharmacy data entry and claims resolution, along with a Pharmacy Technician License. Candidates must possess strong communication skills and the ability to type 40 WPM with accuracy.
RN/LPN PRN 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 Care
Specialization
Candidates must hold a current unrestricted nursing license in Georgia. Experience in mental health or chemical dependency treatment is preferred, along with the ability to communicate effectively and compassionately.
LPN PRN Nights at Evoraa Healthcare
Madison, Tennessee, 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 Care, Patient Confidentiality, Clinical Documentation
Specialization
Candidates must hold a current unrestricted LPN license in Tennessee. Ability to work compassionately with individuals in mental health or chemical dependency treatment is required.
Senior Examiner, Claims at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Claims Examination, Claims Adjudication, Medical Coding, Fraud Detection, Case Management, Regulatory Compliance, Data Entry, Time Management, Customer Service, Microsoft Office Suite, Written Communication, Verbal Communication
Specialization
Requires at least 2 years of experience in claims or clerical customer service, preferably within a managed care setting. Proficiency in Microsoft Office and strong organizational and communication skills are essential.
Experience Required
Minimum 2 year(s)
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)