Molina Healthcare

Lead, Core Operations

Molina Healthcare$75K — $95K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Associate's degree or equivalent experience
  • 3 years of billing, claims review, or processing experience
  • 3 years of experience in managed care or the healthcare industry
  • Strong knowledge of claims processes and quality improvement initiatives
  • Ability to perform troubleshooting procedures and implement process enhancements

Responsibilities

  • Monitor and control claims backlog and workflow
  • Coordinate daily activities and staffing with Supervisor and Manager
  • Perform troubleshooting to support team functions
  • Lead or participate in quality improvement efforts for claims processes
  • Implement processes to boost productivity and efficiency
  • Provide subject matter expertise and training to team members
  • Validate insurance company information and update claims databases

Benefits

  • Comprehensive health and wellness packages
  • Supportive work environment with reasonable accommodations
  • Opportunities for professional growth and development
  • Participation in quality improvement initiatives
Full Job Description
Job Description

Job Summary

Molina Healthcare Services (HCS) is required by CMS and state agencies to coordinate benefits when other carriers are responsible for payment. This requires the maintenance of other insurance records and has a direct impact on medical expenses and premium reimbursement.

Knowledge/Skills/Abilities
  • Monitors and controls backlog and workflow of claims.
  • With Supervisor and Manager, coordinates workflow and staffing of day-to-day activities as well as assigns and monitors work of staff in order to adhere to productivity and quality standards.
  • Perform daily troubleshooting procedures to support team functions as needed.
  • Participates in or leads quality improvement efforts to improve claims processes and/or policies.
  • Implement processes to increase productivity and efficiency
  • Serve as subject matter expert and provide feedback to team personnel and provide training as needed.
  • Phones or utilizes other insurance company portals to validate state, vendor and internal COB leads.
  • Review, validate and make updates to the other insurance table on the claims transactional system and COB tracking database.


REQUIRED EDUCATION:

Associate's degree or equivalent experience

REQUIRED EXPERIENCE:

3 years' experience in a billing, claims review or processing.

3 years' experience in managed care or health care industry.

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
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.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals.

Molina Healthcare Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ

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