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Field Care Manager, LTSS (RN) - Local Travel Required at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Registered Nurse, Care Management, Waiver Assessments, Care Coordination, Care Planning, Medical Necessity, Interdisciplinary Care Team, Motivational Interviewing, Case Management, Microsoft Office Suite, Outlook, Excel, Teams, Time Management, Problem Solving, Critical Thinking
Specialization
Candidates must be a Registered Nurse (RN) with an active and unrestricted license, possessing at least two years of healthcare experience, including one year in care management or managed care, and one year working with populations with disabilities or chronic conditions (LTSS). A valid driver's license, reliable transportation, proficiency in Microsoft Office Suite, and the ability to work independently are also required.
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
Registered Nurse, Care Management, Long Term Services And Supports, Waiver Assessments, Care Coordination, Medicaid, Home Visits, Care Planning, Behavioral Health, Medical Necessity Assessment, Motivational Interviewing, Microsoft Office Suite, Outlook, Excel, Teams, Time Management
Specialization
Candidates must be a Registered Nurse (RN) with an active and unrestricted license, possessing at least two years of healthcare experience, including one year in care management or managed care, and one year working with populations with disabilities or chronic conditions. A valid driver's license, reliable transportation, and proficiency in Microsoft Office Suite are also required.
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
Registered Nurse, Care Management, Waiver Assessments, Care Coordination, Ltss, Medicaid, Home Visits, Care Planning, Behavioral Health, Medical Necessity, Motivational Interviewing, Time Management, Problem Solving, Critical Thinking, Microsoft Office Suite, Outlook
Specialization
Candidates must be a Registered Nurse (RN) with an active and unrestricted license, possessing at least two years of healthcare experience, including one year in care management or managed care, and one year working with populations with disabilities or chronic conditions. A valid driver's license, reliable transportation, and proficiency in Microsoft Office Suite are also required.
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
Registered Nurse (Rn), Care Management, Managed Care, Waiver Assessments, Care Planning, Medical Necessity, Interdisciplinary Care Team (Ict), Motivational Interviewing, Community Resources, Time Management, Problem Solving, Critical Thinking, Microsoft Office Suite, Outlook, Excel, Teams
Specialization
Candidates must be a Registered Nurse (RN) with at least two years of healthcare experience, including one year in care management or managed care, and one year working with populations with disabilities or chronic conditions. A valid driver's license, reliable transportation, and proficiency in Microsoft Office Suite are mandatory requirements.
Experience Required
Minimum 2 year(s)
Care Manager (BH Licensed, Remote in UT) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Case Management, Behavioral Health Assessments, Care Planning, Telephonic Communication, Interdisciplinary Team Collaboration, Motivational Interviewing, Data Entry, Attention To Detail, Computer Skills, Caseload Management, Discharge Planning Coordination, Clinical Judgment, Substance Abuse Population Support, Ltss Integration
Specialization
Candidates must possess at least two years of healthcare experience, preferably in behavioral health, and hold an active, unrestricted behavioral health clinician license such as LCSW, LPC, or LMFT in the state of practice. Required qualifications also include excellent computer skills, experience with severe mental illness populations, and the ability to travel locally up to 25-40%.
Experience Required
Minimum 2 year(s)
Certified Medical Assistant at Suvida Healthcare
Austin, Texas, United States - Full Time
Skills Needed
Phlebotomy, Venipuncture, Medication Administration, Minor Procedures, Wound Care, Suture Removal, Staple Removal, Diagnostic Testing Assistance, Vitals, Medical History Update, Remote Patient Monitoring Support, Verbal Communication, Organization, Professionalism, Confidentiality, Bedside Manner
Specialization
Candidates must possess a High School Diploma or equivalent and hold a current Certification or Registration with CCMA, CMA, RMA, or NCMA. Required abilities include strong verbal communication, excellent organization, professionalism, and a positive bedside manner, with bilingual skills in English and Spanish being preferred.
Director of Compliance and Quality at Ascend Healthcare
, , - Full Time
Skills Needed
Regulatory Compliance, Risk Management, Quality Improvement, Hrsa, Cms, Hipaa, Fqhc, Audits, Internal Audits, Data Analysis, Performance Metrics, Root Cause Analysis, Uds Reporting, Policy Development, Incident Investigation, Staff Training
Specialization
Required qualifications include a Bachelor's degree in a relevant field (nursing, health administration, public health) and a minimum of four years of experience in healthcare compliance and quality improvement, specifically within an FQHC or similar safety-net organization. Strong understanding of HRSA, CMS, HIPAA, FTCA, and PCMH standards, along with excellent analytical and communication skills, is essential.
Experience Required
Minimum 2 year(s)
Senior Medical Director (IPA- Based in CA) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Leadership, Medical Necessity, Utilization Management, Quality Management, Prior Authorization, Inpatient Concurrent Review, Discharge Planning, Care Management, Data Analysis, Policy Development, Peer Review, Regulatory Compliance, Strategic Decision Making, Consensus Building, Financial Acumen, Evidence Based Clinical Criteria
Specialization
Candidates must possess an MD or DO degree with active, unrestricted licensure and Board Certification, along with a minimum of 8 years of relevant experience including clinical practice and 2 years as a medical director in managed care supporting utilization/quality management. A minimum of 3 years of management/leadership experience is also required.
Experience Required
Minimum 5 year(s)
Senior Specialist, Appeals & Grievances at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Appeals, Grievances, Claims Processing, Research, Medical Records Review, Regulatory Compliance, Customer Service, Time Management, Verbal Communication, Written Communication, Coordination Of Benefits, Subrogation, Eligibility Criteria, Medicaid, Medicare, Microsoft Office
Specialization
Candidates must possess at least three years of managed care experience in claims, appeals, or a call center environment, including specific experience with Medicaid and Medicare claims denials and appeals processing. Strong organizational, time management, and communication skills are essential for handling simultaneous tasks and preparing accurate correspondence.
Experience Required
Minimum 2 year(s)
Psychiatric Nurse Practitioner Part-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Board Certified, Compassion, Provider Judgment, Communication Skills, Teamwork, Self Starter, Problem Solver, Behavioral Health Experience, Prescriptive Authority, X Waiver
Specialization
Candidates must possess a Master's Degree in Nursing and be a licensed, board-certified Psychiatric Nurse Practitioner (PMHNP) or an FNP with behavioral health experience from an accredited program. Preferred qualifications include an X-Waiver, and the ability to handle complex patient situations non-judgmentally is essential.
Experience Required
Minimum 2 year(s)
RN/LPN Full-time Nightshift at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Medication Administration, Vital Signs Taking, Medical Assessment, Client Admissions, Client Discharges, Hipaa Compliance, Client Confidentiality, Blood Draws, Tb Testing, Genesight Swabbing, Compassionate Interaction, Record Keeping, Policy Adherence
Specialization
Candidates must possess current, unrestricted licensure as an RN or LPN in Georgia and demonstrate the ability to effectively communicate both orally and in writing. Experience working non-judgmentally with chemically dependent individuals and those in psychiatric care is required, with prior experience in recovery or mental health treatment being a plus.
RN/LPN Part-time Nightshift at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Medication Administration, Vital Signs, Medical Assessment, Client Admissions, Client Discharges, Observation Recording, Hipaa Compliance, Confidentiality, Compassionate Interaction, Staff Training, Pharmacy Communication, Blood Draws, Tb Testing, Genesight Swabbing
Specialization
Minimum qualifications require current, unrestricted licensure as an RN or LPN in Tennessee, along with the ability to effectively communicate and analyze policies. Candidates must be able to work compassionately with chemically dependent individuals and those in psychiatric care.
RN/LPN Part-time Nightshift at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Medication Administration, Vital Signs, Medical Assessment, Client Admissions, Client Discharges, Record Keeping, Hipaa Compliance, Confidentiality, Compassionate Interaction, Safety Maintenance, Staff Training, Blood Draws, Tb Testing, Genesight Swabbing
Specialization
Candidates must possess a current, unrestricted LPN or RN license in Georgia and demonstrate the ability to effectively communicate both orally and in writing. A non-judgmental and compassionate approach when working with chemically dependent individuals and those in psychiatric care is required.
Cook Part-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Meal Preparation, Food Safety, Nutrition, Portion Control, Inventory Management, Sanitation, Client Interaction, Compliance, Cooking, Cleaning, Documentation, Teamwork, Time Management, Ethics, Self Help Program, Food Handler Certification
Specialization
A high school diploma or GED is preferred, along with a Food Handler Certificate. Candidates must have no felonies in the last five years and must demonstrate continuous sobriety if recovering from substance abuse.
Manager, Network Programs (New York Health Plan - EST HOURS) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Network Programs Management, Provider Negotiations, Claim Resolution, Cost Containment, Operational Efficiency, Regulatory Compliance, Risk Mitigation, Quality Audits, Data Analysis, Process Improvement, Team Leadership, Out Of Network Claims, Independent Dispute Resolution, Performance Metrics, Contract Management
Specialization
Candidates must possess at least five years of contract-related experience in healthcare, including managed care or insurance entities, with a minimum of three years specifically in provider contract negotiations across various provider types. Additionally, at least one year of management or leadership experience is required.
Experience Required
Minimum 5 year(s)
Senior Analyst, Provider Configuration (Remote) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Provider Configuration, Data Maintenance, Data Synchronization, Data Validation, Contracting, Network Management, Credentialing, Data Auditing, Sop Development, Brd Development, Configuration Standards, Process Improvement, Claims Payment System Upgrades, Test Plan Execution, Critical Thinking, Time Management
Specialization
Candidates must possess at least four years of healthcare experience, preferably in a provider services setting, along with strong critical-thinking and organizational skills to manage simultaneous tasks effectively. Proficiency in the Microsoft Office suite, especially Excel, is required, alongside effective verbal and written communication abilities.
Experience Required
Minimum 2 year(s)
RN/LPN Part-time Dayshift at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Administering Medication, Taking Vitals, Medical Assessment, Client Admissions, Client Discharges, Hipaa Compliance, Client Confidentiality, Compassionate Interaction, Data Collection, Problem Definition, Effective Communication, Working With Chemically Dependent Individuals, Working With Psychiatric Care Patients
Specialization
Minimum qualifications require current, unrestricted licensure as an RN or LPN in Georgia, along with the ability to effectively communicate and interpret policies. Candidates must be able to work compassionately with chemically dependent individuals and those in psychiatric care.
Specialist, Appeals & Grievances at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Appeals, Grievances, Claims Processing, Research, Resolution, Regulatory Compliance, Medical Records Review, 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)
Manager, Care Connections Outreach & Engagement at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Team Leadership, Outreach Initiatives, Dialer Strategies, Performance Management, Member Interactions, Strategy Development, Analytical Skills, Problem Solving, Communication, Scheduling Optimization, Training, Hipaa Compliance, Electronic Medical Record, Escalation Handling, Stakeholder Relationships
Specialization
Candidates must possess at least 7 years of administrative support experience in healthcare, including a minimum of 1 year in a management or leadership capacity. Required qualifications also include strong analytical, communication, problem-solving skills, proficiency in Word and Excel, and experience documenting in an electronic medical record system.
Experience Required
Minimum 5 year(s)
Care Manager, LTSS (RN/SW) - Must reside in IA at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Care Management, Care Coordination, Long Term Services And Supports, Multidisciplinary Team Collaboration, Member Assessments, Waiver Enrollment, Care Plan Development, Motivational Interviewing, Medical Necessity Authorization, Interdisciplinary Care Team Meetings, Time Management, Problem Solving, Critical Thinking, Communication, Microsoft Office Suite, Detail Oriented
Specialization
Candidates must have at least two years of healthcare experience, including one year working with persons with disabilities/chronic conditions in LTSS, and one year in care management or a medical/behavioral health setting. A valid and unrestricted driver's license, reliable transportation, and active clinical licensure (if mandated by state) are required.
Experience Required
Minimum 2 year(s)
Field Care Manager, LTSS (RN) - Local Travel Required at Molina Healthcare
Long Beach, California, United States -
Full Time

Start Date

Immediate

Expiry Date

20 May, 26

Salary

0.0

Posted On

19 Feb, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Registered Nurse, Care Management, Waiver Assessments, Care Coordination, Care Planning, Medical Necessity, Interdisciplinary Care Team, Motivational Interviewing, Case Management, Microsoft Office Suite, Outlook, Excel, Teams, Time-Management, Problem-Solving, Critical-Thinking

Industry

Hospitals and Health Care

Description
JOB DESCRIPTION Opportunity for TX RN to join Molina as a Care Manager working with our Medicare members in the Hidalgo service delivery area. Responsibilities include completing face-to-face waiver assessments with our Medicare members there. Preference will be given to those with this type of experience having worked for an MCO organization like Molina, and who live within a 30 minute radius around the community. Hours are Monday – Friday, 8 AM – 5 PM CST and mileage is reimbursed as part of our benefit package. Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation. Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. • Facilitates comprehensive waiver enrollment and disenrollment processes. • Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. • Assesses for medical necessity and authorizes all appropriate waiver services. • Evaluates covered benefits and advises appropriately regarding funding sources. • Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. • Identifies critical incidents and develops prevention plans to assure member health and welfare. • May provide consultation, resources and recommendations to peers as needed. • Care manager RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Ability to operate proactively and demonstrate detail-oriented work. • Demonstrated knowledge of community resources. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations. • Ability to work independently, with minimal supervision and demonstrate self-motivation. • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. • In some states, must have at least one year of experience working directly with individuals with substance use disorders. Preferred Qualifications • Certified Case Manager (CCM). • Experience working with populations that receive waiver services. 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 role involves providing support for long-term services and supports care management/coordination, collaborating with multidisciplinary teams to ensure integrated delivery of care across the continuum for high-need Medicare members. Essential duties include completing comprehensive member assessments, facilitating waiver enrollment, developing care plans, and monitoring progress toward desired outcomes while ensuring quality and cost-effective care.
Field Care Manager, LTSS (RN) - Local Travel Required at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Registered Nurse, Care Management, Waiver Assessments, Care Coordination, Care Planning, Medical Necessity, Interdisciplinary Care Team, Motivational Interviewing, Case Management, Microsoft Office Suite, Outlook, Excel, Teams, Time Management, Problem Solving, Critical Thinking
Specialization
Candidates must be a Registered Nurse (RN) with an active and unrestricted license, possessing at least two years of healthcare experience, including one year in care management or managed care, and one year working with populations with disabilities or chronic conditions (LTSS). A valid driver's license, reliable transportation, proficiency in Microsoft Office Suite, and the ability to work independently are also required.
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
Registered Nurse, Care Management, Long Term Services And Supports, Waiver Assessments, Care Coordination, Medicaid, Home Visits, Care Planning, Behavioral Health, Medical Necessity Assessment, Motivational Interviewing, Microsoft Office Suite, Outlook, Excel, Teams, Time Management
Specialization
Candidates must be a Registered Nurse (RN) with an active and unrestricted license, possessing at least two years of healthcare experience, including one year in care management or managed care, and one year working with populations with disabilities or chronic conditions. A valid driver's license, reliable transportation, and proficiency in Microsoft Office Suite are also required.
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
Registered Nurse, Care Management, Waiver Assessments, Care Coordination, Ltss, Medicaid, Home Visits, Care Planning, Behavioral Health, Medical Necessity, Motivational Interviewing, Time Management, Problem Solving, Critical Thinking, Microsoft Office Suite, Outlook
Specialization
Candidates must be a Registered Nurse (RN) with an active and unrestricted license, possessing at least two years of healthcare experience, including one year in care management or managed care, and one year working with populations with disabilities or chronic conditions. A valid driver's license, reliable transportation, and proficiency in Microsoft Office Suite are also required.
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
Registered Nurse (Rn), Care Management, Managed Care, Waiver Assessments, Care Planning, Medical Necessity, Interdisciplinary Care Team (Ict), Motivational Interviewing, Community Resources, Time Management, Problem Solving, Critical Thinking, Microsoft Office Suite, Outlook, Excel, Teams
Specialization
Candidates must be a Registered Nurse (RN) with at least two years of healthcare experience, including one year in care management or managed care, and one year working with populations with disabilities or chronic conditions. A valid driver's license, reliable transportation, and proficiency in Microsoft Office Suite are mandatory requirements.
Experience Required
Minimum 2 year(s)
Care Manager (BH Licensed, Remote in UT) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Case Management, Behavioral Health Assessments, Care Planning, Telephonic Communication, Interdisciplinary Team Collaboration, Motivational Interviewing, Data Entry, Attention To Detail, Computer Skills, Caseload Management, Discharge Planning Coordination, Clinical Judgment, Substance Abuse Population Support, Ltss Integration
Specialization
Candidates must possess at least two years of healthcare experience, preferably in behavioral health, and hold an active, unrestricted behavioral health clinician license such as LCSW, LPC, or LMFT in the state of practice. Required qualifications also include excellent computer skills, experience with severe mental illness populations, and the ability to travel locally up to 25-40%.
Experience Required
Minimum 2 year(s)
Certified Medical Assistant at Suvida Healthcare
Austin, Texas, United States - Full Time
Skills Needed
Phlebotomy, Venipuncture, Medication Administration, Minor Procedures, Wound Care, Suture Removal, Staple Removal, Diagnostic Testing Assistance, Vitals, Medical History Update, Remote Patient Monitoring Support, Verbal Communication, Organization, Professionalism, Confidentiality, Bedside Manner
Specialization
Candidates must possess a High School Diploma or equivalent and hold a current Certification or Registration with CCMA, CMA, RMA, or NCMA. Required abilities include strong verbal communication, excellent organization, professionalism, and a positive bedside manner, with bilingual skills in English and Spanish being preferred.
Director of Compliance and Quality at Ascend Healthcare
, , - Full Time
Skills Needed
Regulatory Compliance, Risk Management, Quality Improvement, Hrsa, Cms, Hipaa, Fqhc, Audits, Internal Audits, Data Analysis, Performance Metrics, Root Cause Analysis, Uds Reporting, Policy Development, Incident Investigation, Staff Training
Specialization
Required qualifications include a Bachelor's degree in a relevant field (nursing, health administration, public health) and a minimum of four years of experience in healthcare compliance and quality improvement, specifically within an FQHC or similar safety-net organization. Strong understanding of HRSA, CMS, HIPAA, FTCA, and PCMH standards, along with excellent analytical and communication skills, is essential.
Experience Required
Minimum 2 year(s)
Senior Medical Director (IPA- Based in CA) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Leadership, Medical Necessity, Utilization Management, Quality Management, Prior Authorization, Inpatient Concurrent Review, Discharge Planning, Care Management, Data Analysis, Policy Development, Peer Review, Regulatory Compliance, Strategic Decision Making, Consensus Building, Financial Acumen, Evidence Based Clinical Criteria
Specialization
Candidates must possess an MD or DO degree with active, unrestricted licensure and Board Certification, along with a minimum of 8 years of relevant experience including clinical practice and 2 years as a medical director in managed care supporting utilization/quality management. A minimum of 3 years of management/leadership experience is also required.
Experience Required
Minimum 5 year(s)
Senior Specialist, Appeals & Grievances at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Appeals, Grievances, Claims Processing, Research, Medical Records Review, Regulatory Compliance, Customer Service, Time Management, Verbal Communication, Written Communication, Coordination Of Benefits, Subrogation, Eligibility Criteria, Medicaid, Medicare, Microsoft Office
Specialization
Candidates must possess at least three years of managed care experience in claims, appeals, or a call center environment, including specific experience with Medicaid and Medicare claims denials and appeals processing. Strong organizational, time management, and communication skills are essential for handling simultaneous tasks and preparing accurate correspondence.
Experience Required
Minimum 2 year(s)
Psychiatric Nurse Practitioner Part-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Board Certified, Compassion, Provider Judgment, Communication Skills, Teamwork, Self Starter, Problem Solver, Behavioral Health Experience, Prescriptive Authority, X Waiver
Specialization
Candidates must possess a Master's Degree in Nursing and be a licensed, board-certified Psychiatric Nurse Practitioner (PMHNP) or an FNP with behavioral health experience from an accredited program. Preferred qualifications include an X-Waiver, and the ability to handle complex patient situations non-judgmentally is essential.
Experience Required
Minimum 2 year(s)
RN/LPN Full-time Nightshift at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Medication Administration, Vital Signs Taking, Medical Assessment, Client Admissions, Client Discharges, Hipaa Compliance, Client Confidentiality, Blood Draws, Tb Testing, Genesight Swabbing, Compassionate Interaction, Record Keeping, Policy Adherence
Specialization
Candidates must possess current, unrestricted licensure as an RN or LPN in Georgia and demonstrate the ability to effectively communicate both orally and in writing. Experience working non-judgmentally with chemically dependent individuals and those in psychiatric care is required, with prior experience in recovery or mental health treatment being a plus.
RN/LPN Part-time Nightshift at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Medication Administration, Vital Signs, Medical Assessment, Client Admissions, Client Discharges, Observation Recording, Hipaa Compliance, Confidentiality, Compassionate Interaction, Staff Training, Pharmacy Communication, Blood Draws, Tb Testing, Genesight Swabbing
Specialization
Minimum qualifications require current, unrestricted licensure as an RN or LPN in Tennessee, along with the ability to effectively communicate and analyze policies. Candidates must be able to work compassionately with chemically dependent individuals and those in psychiatric care.
RN/LPN Part-time Nightshift at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Medication Administration, Vital Signs, Medical Assessment, Client Admissions, Client Discharges, Record Keeping, Hipaa Compliance, Confidentiality, Compassionate Interaction, Safety Maintenance, Staff Training, Blood Draws, Tb Testing, Genesight Swabbing
Specialization
Candidates must possess a current, unrestricted LPN or RN license in Georgia and demonstrate the ability to effectively communicate both orally and in writing. A non-judgmental and compassionate approach when working with chemically dependent individuals and those in psychiatric care is required.
Cook Part-time at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Meal Preparation, Food Safety, Nutrition, Portion Control, Inventory Management, Sanitation, Client Interaction, Compliance, Cooking, Cleaning, Documentation, Teamwork, Time Management, Ethics, Self Help Program, Food Handler Certification
Specialization
A high school diploma or GED is preferred, along with a Food Handler Certificate. Candidates must have no felonies in the last five years and must demonstrate continuous sobriety if recovering from substance abuse.
Manager, Network Programs (New York Health Plan - EST HOURS) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Network Programs Management, Provider Negotiations, Claim Resolution, Cost Containment, Operational Efficiency, Regulatory Compliance, Risk Mitigation, Quality Audits, Data Analysis, Process Improvement, Team Leadership, Out Of Network Claims, Independent Dispute Resolution, Performance Metrics, Contract Management
Specialization
Candidates must possess at least five years of contract-related experience in healthcare, including managed care or insurance entities, with a minimum of three years specifically in provider contract negotiations across various provider types. Additionally, at least one year of management or leadership experience is required.
Experience Required
Minimum 5 year(s)
Senior Analyst, Provider Configuration (Remote) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Provider Configuration, Data Maintenance, Data Synchronization, Data Validation, Contracting, Network Management, Credentialing, Data Auditing, Sop Development, Brd Development, Configuration Standards, Process Improvement, Claims Payment System Upgrades, Test Plan Execution, Critical Thinking, Time Management
Specialization
Candidates must possess at least four years of healthcare experience, preferably in a provider services setting, along with strong critical-thinking and organizational skills to manage simultaneous tasks effectively. Proficiency in the Microsoft Office suite, especially Excel, is required, alongside effective verbal and written communication abilities.
Experience Required
Minimum 2 year(s)
RN/LPN Part-time Dayshift at Evoraa Healthcare
Kingston, Georgia, United States - Full Time
Skills Needed
Administering Medication, Taking Vitals, Medical Assessment, Client Admissions, Client Discharges, Hipaa Compliance, Client Confidentiality, Compassionate Interaction, Data Collection, Problem Definition, Effective Communication, Working With Chemically Dependent Individuals, Working With Psychiatric Care Patients
Specialization
Minimum qualifications require current, unrestricted licensure as an RN or LPN in Georgia, along with the ability to effectively communicate and interpret policies. Candidates must be able to work compassionately with chemically dependent individuals and those in psychiatric care.
Specialist, Appeals & Grievances at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Appeals, Grievances, Claims Processing, Research, Resolution, Regulatory Compliance, Medical Records Review, 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)
Manager, Care Connections Outreach & Engagement at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Team Leadership, Outreach Initiatives, Dialer Strategies, Performance Management, Member Interactions, Strategy Development, Analytical Skills, Problem Solving, Communication, Scheduling Optimization, Training, Hipaa Compliance, Electronic Medical Record, Escalation Handling, Stakeholder Relationships
Specialization
Candidates must possess at least 7 years of administrative support experience in healthcare, including a minimum of 1 year in a management or leadership capacity. Required qualifications also include strong analytical, communication, problem-solving skills, proficiency in Word and Excel, and experience documenting in an electronic medical record system.
Experience Required
Minimum 5 year(s)
Care Manager, LTSS (RN/SW) - Must reside in IA at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Care Management, Care Coordination, Long Term Services And Supports, Multidisciplinary Team Collaboration, Member Assessments, Waiver Enrollment, Care Plan Development, Motivational Interviewing, Medical Necessity Authorization, Interdisciplinary Care Team Meetings, Time Management, Problem Solving, Critical Thinking, Communication, Microsoft Office Suite, Detail Oriented
Specialization
Candidates must have at least two years of healthcare experience, including one year working with persons with disabilities/chronic conditions in LTSS, and one year in care management or a medical/behavioral health setting. A valid and unrestricted driver's license, reliable transportation, and active clinical licensure (if mandated by state) are required.
Experience Required
Minimum 2 year(s)