Top 1027 Molina healthcare Jobs

Representative, Health Plan Provider Relations - Remote Must reside in NY
Molina Healthcare —New York, NY
- $19.84 - $46.42 an hour
- Full-time
- Remote
- Medical office experience
- Mid-level
- Travel
- Health insurance
Associate Representative, Health Plan Provider Relations - Remote must reside in UT
Molina Healthcare —Utah
- $18.04 - $35.17 an hour
- Full-time
- Remote
- Medical office experience
- Research
- Communication skills
- Health insurance
13d
Representative, Enrollment - Remote in Madison or Milwaukee
Molina Healthcare —Madison, WI
- $13.55 - $26.42 an hour
- Full-time
- Remote
- HIPAA
- Research
- Data entry
- Health insurance
14d
Representative, Enrollment - Remote in Madison or Milwaukee
Molina Healthcare —Milwaukee, WI
- $13.55 - $26.42 an hour
- Full-time
- Remote
- HIPAA
- Research
- Data entry
- Health insurance
14d
Field Nurse Practitioner (Panama City and Ocala Florida locations)
Molina Healthcare —Miami Beach, FL
- $88,453 - $172,484 a year
- Full-time
- Bilingual
- Skilled nursing facility
- BLS Certification
- Health insurance
Field Nurse Practitioner (Galesburg, IL)
Molina Healthcare —Galesburg, IL
- $92,876 - $181,108 a year
- Full-time
- Bilingual
- Skilled nursing facility
- BLS Certification
- Health insurance
Field Nurse Practitioner (Okanogan, WA)
Molina Healthcare —Okanogan, WA
- $88,453 - $198,356 a year
- Full-time
- Bilingual
- Skilled nursing facility
- BLS Certification
- Health insurance
Field Nurse Practitioner (Omaha, NE)
Molina Healthcare —Omaha, NE
- $84,031.00 - $172,483.80 a year
- Full-time
- Bilingual
- Skilled nursing facility
- BLS Certification
- Health insurance
(RN)Care Manager, Long Term Support Services (Massachusetts based- local travel required)
Molina Healthcare —New Bedford, MA
- $30.37 - $59.21 an hour
- Full-time
- RN License
- Experience working with individuals with disabilities
- Mid-level
- Health insurance
RN - Transition of Care Coach
Molina Healthcare —Mississippi City, MS
- $23.76 - $51.49 an hour
- Full-time
- Acute care
- Up to 50% travel
- RN License
- Health insurance
Care Manager (RN- New Mexico based)
Molina Healthcare —Bernalillo, NM
- $26.41 - $51.49 an hour
- Full-time
- RN License
- HIPAA
- Mid-level
- Health insurance
Care Manager, LTSS (RN) - (Remote in Boston, MA)
Molina Healthcare —Boston, MA
- $30.37 - $59.21 an hour
- Full-time
- RN License
- Experience working with individuals with disabilities
- Mid-level
- Health insurance
RN Care Manager
Molina Healthcare —Mississippi City, MS
- $23.76 - $51.49 an hour
- Full-time
- RN License
- HIPAA
- Mid-level
- Health insurance
Field Care Manager, LTSS (RN) - Local Travel Required, NE Houston
Molina Healthcare —Houston, TX
- $26.41 - $51.49 an hour
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health insurance
RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
Molina Healthcare —San Francisco, CA
- $30.37 - $59.21 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Discharge planning
- Health insurance
Representative, Support Center (Bilingual English/Spanish, Must Reside in FL)
Molina Healthcare —Miami, FL
- $14.00 - $28.82 an hour
- Overtime
- Spanish
- Sales
- Computer literacy
- Health insurance
Pharmacy CSR Bilingual Spanish (Remote, Must Live in Florida)
Molina Healthcare —Miami, FL
- $14.00 - $24.02 an hour
- Full-time
- Remote
- Spanish
- 1 year
- Communication skills
8d
HOPE Navigator (Social & Health Equity Navigator) Must Live In FL (Remote)
Molina Healthcare —Miami, FL
- $24.00 - $46.81 an hour
- Full-time
- Remote
- HIPAA
- Mid-level
- Travel
- Health insurance
Representative, Support Center (Bilingual English/Spanish, Must Reside in FL)
Molina Healthcare, Inc. —Naples, FL
- $14.00 - $24.02 an hour
- Overtime
- Spanish
- Sales
- Computer literacy
- Health insurance
Representative, Health Plan Provider Relations (( Wisconsin long-term services and supports (LTSS) Provider Quality; must reside in Wisconsin)
Molina Healthcare —Wisconsin Rapids, WI
- $19.84 - $38.69 an hour
- Full-time
- Medical office experience
- Mid-level
- Residential
- Health insurance

I want to receive the latest job alert for molina healthcare

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

molina healthcare jobs near

Representative, Health Plan Provider Relations - Remote Must reside in NY

Molina Healthcare -
New York, NY

Apply Now

Job Details

Full-time
$19.84 - $46.42 an hour

Benefits

Health insurance

Qualifications

Customer communication
Managed care
Managed care organization experience
Medical office experience
Schedule management
Health insurance knowledge
Productivity software
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION Job Summary

Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.

Essential Job Duties

Successfully engages high-volume, high-visibility plan providers, to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.
Serves as the primary point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.
Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.
Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.
Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).
Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).
May provide training and support to new and existing provider relations team members as appropriate.

will require to travel at least once a week subject to change.

Required Qualifications

At least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.
General understanding of the health care delivery system, including government-sponsored health plans.
Organizational skills and attention to detail.
Ability to manage multiple tasks and deadlines effectively.
Interpersonal skills, including ability to interface with providers and medical office staff.
Ability to work in a cross-functional highly matrixed organization.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.
Experience delivering training and facilitating educational presentations.

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

Pay Range: $19.84 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

molina healthcare jobs

Representative, Health Plan Provider Relations - Remote Must reside in NY

Associate Representative, Health Plan Provider Relations - Remote must reside in UT

Representative, Enrollment - Remote in Madison or Milwaukee

Representative, Enrollment - Remote in Madison or Milwaukee

Field Nurse Practitioner (Panama City and Ocala Florida locations)

Field Nurse Practitioner (Galesburg, IL)

Field Nurse Practitioner (Okanogan, WA)

Field Nurse Practitioner (Omaha, NE)

(RN)Care Manager, Long Term Support Services (Massachusetts based- local travel required)

RN - Transition of Care Coach

Care Manager (RN- New Mexico based)

Care Manager, LTSS (RN) - (Remote in Boston, MA)

RN Care Manager

Field Care Manager, LTSS (RN) - Local Travel Required, NE Houston

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)

Representative, Support Center (Bilingual English/Spanish, Must Reside in FL)

Pharmacy CSR Bilingual Spanish (Remote, Must Live in Florida)

HOPE Navigator (Social & Health Equity Navigator) Must Live In FL (Remote)

Representative, Support Center (Bilingual English/Spanish, Must Reside in FL)

Representative, Health Plan Provider Relations (( Wisconsin long-term services and supports (LTSS) Provider Quality; must reside in Wisconsin)

I want to receive the latest job alert for molina healthcare

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected