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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)
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, Onboarding, Training, Hipaa Compliance, Electronic Medical Record, Adaptability, Bilingual
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 skills include strong analytical abilities, proficiency in Word and Excel, experience with EMR documentation, and bilingual capability.
Experience Required
Minimum 5 year(s)
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)
Field Nurse Practitioner (Chehalis, WA) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Primary Care, Care Coordination, Comprehensive Evaluations, Chronic Disease Management, Acute Care, Medical Diagnosis, Diagnostic Testing, Medical Plan Of Care, Post Discharge Coordination, On Call Coverage, Community Outreach, Cross State Licensing, Medical Records Documentation, Emr Proficiency, Time Management, Problem Solving
Specialization
Candidates must possess at least 1 year of experience as a Nurse Practitioner, hold active and unrestricted national certification (AANP or ANCC), and maintain current state licensure as an FNP with an active DEA prescriber license. A valid driver's license, reliable transportation, and the ability to work independently are also mandatory requirements.
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, Communication, Time Management, Organizational Skills, Customer Service, Coordination Of Benefits, Subrogation, Eligibility Criteria, Microsoft Office Suite
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 processing Medicaid and Medicare claims denials and appeals. Strong organizational skills and proficiency in written and verbal communication are essential for meeting production standards and regulatory requirements.
Experience Required
Minimum 2 year(s)
Pre-Admission Testing Nurse at MEDRVA Healthcare
Richmond, Virginia, United States - Full Time
Skills Needed
Verbal Assessment, Patient Triage, Communication Skills, Patient Education, Documentation, Teamwork, Customer Service, Surgical Procedures, Anesthesia Techniques, Emotional Support, Professional Demeanor, Self Directed, Flexibility, Safety Protocols, Problem Solving, Time Management
Specialization
Candidates must be graduates of an accredited School of Nursing with a minimum of 2 years of experience in an OR, PACU, or ICU setting. A current VA RN License and BLS, ACLS certification are also required.
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)
Medical Review Nurse (RN) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Clinical Nursing, Utilization Review, Medical Claims Review, Long Term Services, Claims Auditing, Medical Necessity Review, Icd 10 Coding, Cpt Coding, Hcpc Coding, Analytic Skills, Problem Solving, Decision Making, Attention To Detail, Communication Skills, Microsoft Office Proficiency
Specialization
Candidates must have at least 2 years of clinical nursing experience, including 1 year in utilization review or related fields. An active RN license and knowledge of coding and regulations 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 Nurse Practitioner (Farmington, NM) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Nurse Practitioner, Medical Care, Care Coordination, Chronic Care Management, Acute Care Management, Diagnostic Testing, Medical Diagnosis, Patient Evaluation, Community Health, Communication Skills, Problem Solving, Time Management, Bilingual, Emr Experience, Basic Life Support, Driving
Specialization
Candidates must have at least 1 year of experience as a nurse practitioner and hold an active national certification and state-issued license. Additional qualifications include a DEA license, BLS certification, and the ability to work independently in diverse settings.
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)
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.
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)
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)
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.
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)
Licensed Primary Therapist at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Individual Therapy, Group Therapy, Family Therapy, Crisis Intervention, Psychoeducation, Psychosocial Assessments, Treatment Planning, Clinical Documentation, Cbt, Dbt, Act, Family Systems, Relapse Prevention, Computer Skills, Organizational Skills, Cpr/First Aid Certification
Specialization
Candidates must possess a Master's degree in counseling, social work, or psychology, along with experience in addictions and mental health diagnoses. Essential requirements include proficiency in various counseling interventions like CBT and DBT, strong communication skills, and holding an unrestricted LCSW, LMFT, LPC, or LPC-MHSP license in Tennessee.
Experience Required
Minimum 2 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)
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.
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

Start Date

Immediate

Expiry Date

29 May, 26

Salary

0.0

Posted On

28 Feb, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

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

Industry

Hospitals and Health Care

Description
Job Description Job Summary Leads and manages teams that drive member outreach initiatives and ensure alignment with Care Connection goals.  Oversees the execution of dialer strategies, manages team performance, and ensures high-quality member interactions. Contributes to overarching strategy to provide quality and cost-effective member care.    Job Duties * Develops and executes dialer strategies in coordination with the Senior Leadership Team (SLT) to meet outreach and engagement goals. * Generates and manages hand-dial lists based on business priorities, ensuring timely and accurate completion by outreach and engagement teams. * Ensure all team members adhere to departmental standards, call quality, and documentation requirements. * Monitors and manages team performance, ensuring all team members meet or exceed role-specific metrics. * Optimize scheduling capacity by reviewing team schedules and collaborating with Nurse Practitioner Leadership and the Scheduling Team. * Supports onboarding and training new team members. * Coordinates shift coverage to meet business needs across all hours of operation. * Handles escalation calls and personally schedules member visits for a minimum of 2 hours per week to stay connected to frontline operations. * Fosters positive relationships with coworkers, members, providers, and stakeholders.   Job Qualifications REQUIRED QUALIFICATIONS: * At least 7 years administrative support experience in healthcare, or equivalent combination of relevant experience and education. * At least 1 year management/leadership experience required.  * Strong analytical skills. * Ability to lead teams in a fast-paced, mission-driven environment. * Strong communication, problem-solving, and collaborative interpersonal skills. * Proficient in computer applications, including Word and Excel. * Experience documenting in an electronic medical record system. * Ability to manage multiple priorities and adapt to change. * Ability to adjust style as needed - working with diverse populations and various personalities and personal situations. * Responsive in all forms of communication - remains calm in high-pressure situations. * Bilingual (English and at least 1 additional language as required). * Knowledge of HIPAA compliance and professional documentation standards. PREFERRED QUALIFICATIONS: * Healthcare administrative support leadership in roles such as Medical Office, Patient Services, Medical Receptionist Teams, Front Desk Coordinator Teams, or Medical Appointment Scheduling Teams. * Experience utilizing Epic for member registration, documentation, and provider scheduling. * Experience with SalesForce, QNXT, or CCA systems. * Experience managing auto dialer platforms and outbound member campaigns. * Experience with PowerBi.     To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Responsibilities
This role involves leading and managing teams responsible for driving member outreach initiatives, overseeing dialer strategies, and ensuring alignment with Care Connection goals. The manager must also contribute to the overarching strategy for providing quality and cost-effective member care.
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)
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, Onboarding, Training, Hipaa Compliance, Electronic Medical Record, Adaptability, Bilingual
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 skills include strong analytical abilities, proficiency in Word and Excel, experience with EMR documentation, and bilingual capability.
Experience Required
Minimum 5 year(s)
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)
Field Nurse Practitioner (Chehalis, WA) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Primary Care, Care Coordination, Comprehensive Evaluations, Chronic Disease Management, Acute Care, Medical Diagnosis, Diagnostic Testing, Medical Plan Of Care, Post Discharge Coordination, On Call Coverage, Community Outreach, Cross State Licensing, Medical Records Documentation, Emr Proficiency, Time Management, Problem Solving
Specialization
Candidates must possess at least 1 year of experience as a Nurse Practitioner, hold active and unrestricted national certification (AANP or ANCC), and maintain current state licensure as an FNP with an active DEA prescriber license. A valid driver's license, reliable transportation, and the ability to work independently are also mandatory requirements.
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, Communication, Time Management, Organizational Skills, Customer Service, Coordination Of Benefits, Subrogation, Eligibility Criteria, Microsoft Office Suite
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 processing Medicaid and Medicare claims denials and appeals. Strong organizational skills and proficiency in written and verbal communication are essential for meeting production standards and regulatory requirements.
Experience Required
Minimum 2 year(s)
Pre-Admission Testing Nurse at MEDRVA Healthcare
Richmond, Virginia, United States - Full Time
Skills Needed
Verbal Assessment, Patient Triage, Communication Skills, Patient Education, Documentation, Teamwork, Customer Service, Surgical Procedures, Anesthesia Techniques, Emotional Support, Professional Demeanor, Self Directed, Flexibility, Safety Protocols, Problem Solving, Time Management
Specialization
Candidates must be graduates of an accredited School of Nursing with a minimum of 2 years of experience in an OR, PACU, or ICU setting. A current VA RN License and BLS, ACLS certification are also required.
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)
Medical Review Nurse (RN) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Clinical Nursing, Utilization Review, Medical Claims Review, Long Term Services, Claims Auditing, Medical Necessity Review, Icd 10 Coding, Cpt Coding, Hcpc Coding, Analytic Skills, Problem Solving, Decision Making, Attention To Detail, Communication Skills, Microsoft Office Proficiency
Specialization
Candidates must have at least 2 years of clinical nursing experience, including 1 year in utilization review or related fields. An active RN license and knowledge of coding and regulations 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 Nurse Practitioner (Farmington, NM) at Molina Healthcare
Long Beach, California, United States - Full Time
Skills Needed
Nurse Practitioner, Medical Care, Care Coordination, Chronic Care Management, Acute Care Management, Diagnostic Testing, Medical Diagnosis, Patient Evaluation, Community Health, Communication Skills, Problem Solving, Time Management, Bilingual, Emr Experience, Basic Life Support, Driving
Specialization
Candidates must have at least 1 year of experience as a nurse practitioner and hold an active national certification and state-issued license. Additional qualifications include a DEA license, BLS certification, and the ability to work independently in diverse settings.
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)
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.
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)
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)
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.
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)
Licensed Primary Therapist at Evoraa Healthcare
Brentwood, Tennessee, United States - Full Time
Skills Needed
Individual Therapy, Group Therapy, Family Therapy, Crisis Intervention, Psychoeducation, Psychosocial Assessments, Treatment Planning, Clinical Documentation, Cbt, Dbt, Act, Family Systems, Relapse Prevention, Computer Skills, Organizational Skills, Cpr/First Aid Certification
Specialization
Candidates must possess a Master's degree in counseling, social work, or psychology, along with experience in addictions and mental health diagnoses. Essential requirements include proficiency in various counseling interventions like CBT and DBT, strong communication skills, and holding an unrestricted LCSW, LMFT, LPC, or LPC-MHSP license in Tennessee.
Experience Required
Minimum 2 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)
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.
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)