Molina Healthcare

Lead, Core Operations

Molina Healthcare$85K — $110K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 4+ years in health care operations, claims, or provider services or equivalent education/experience
  • Customer service experience
  • Knowledge of Medicare, Medicaid, and Marketplace plans
  • Experience in a Medicaid or large claims processing environment
  • Strong organizational and time-management skills
  • Ability to work collaboratively in a matrixed organization
  • Proficiency in Microsoft Office and relevant software

Responsibilities

  • Manage escalations in departmental operations with accountability and urgency
  • Perform troubleshooting for enrollment, disenrollment, claims and support processes
  • Coordinate daily workflow and staffing; assign and monitor staff work
  • Lead or participate in quality improvement initiatives for claims processes
  • Act as a subject matter expert; provide training and support to team members

Benefits

  • Competitive benefits package
  • Opportunities for career development
  • Supportive work environment
  • Basic healthcare benefits
  • Potential for internal mobility within the organization
Full Job Description
Job Description

JOB DESCRIPTION Job Summary

Provides lead level support for core operations activities including claims processing, benefit interpretation, provider services, provider enrollment, etc., ensuring functional operations and contractual compliance.

Essential Job Duties
• Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow-through to closure.
• Performs daily troubleshooting procedures to support enrollment, disenrollment, claims, and claims support functions as needed.
• Coordinates workflow and staffing of day-to-day activities, and assigns and monitors work of staff to adhere to productivity and quality standards.
• Participates in or leads quality improvement efforts to improve claims processes and/or policies.
• Serves as operations subject matter expert, provides training, mentoring and support to team personnel.

Job Requirements
• At least 4 years of health care operations/claims/provider services experience, or equivalent combination of relevant education and experience.
• Customer service experience.
• Knowledge of Medicare, Medicaid, and Marketplace plans.
• Experience supporting a Medicaid or large claims processing environment with multi-functional work units and tasks.
• Organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
• Ability to work cross-collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders.
• Effective verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software programs proficiency.

#PJCore

#LI-AC1

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

Similar Jobs

More Jobs at Molina Healthcare

More Healthcare Jobs

Find similar Lead, Core Operations jobs: