Jobs at Molina Healthcare in Long Beach, CA

The AVP, Core Operations is responsible for planning, developing, and directing the implementation of techniques to ensure the maintenance of performance and quality levels in the Business' products a...

Responsible for developing and implementing a multi-faceted program dedicated to evaluating member success and program outcomes. Interfaces with local and national business partners, customers, and re...

Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database...

Responsible for the Management of internal business projects and programs involving department or cross-functional teams of subject matter experts.

The Director of Care Management is responsible for overseeing key healthcare services functions and ensuring integrated proactive care review and management. They collaborate with leadership, develop...

The Mgr, Operations is responsible for providing leadership and direction to various operational units within the organization. They oversee daily functional operations, ensure compliance with contrac...

Telephonic Case Manager (RN) - CA License

The Director of Broker Services is responsible for overseeing the sales and growth support model for Medicare, Medicaid, and Marketplace lines of business...

The Project Manager is responsible for planning, directing, and monitoring projects from inception through delivery. They manage all aspects of assigned projects, including scope, schedule, resources...

Supervisor responsible for leading and organizing the Grievance and Appeals Unit, resolving member and provider complaints, and ensuring compliance with regulatory requirements...

Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases...

The LTSS RN Case Manager - Weslaco position requires case management experience, strong time management skills, and the ability to handle a large volume of members. Bilingual skills are preferred...

AVP, Network Strategy & Svcs is a leadership position responsible for developing and implementing provider network and contract strategies, overseeing contract negotiations, and facilitating communica...

The Director of Provider Relations is responsible for network development, network adequacy, and provider training and education in Southern California...

The RN Care Review Clinician Inpatient Review - CA - Pediatric UM position requires a licensed RN in California with 2-3 years of pediatric experience in Utilization Management (UM) and bilingual prof...

The Sr Provider Network Data Management Analyst is responsible for accessing, integrating, and analyzing data from various healthcare systems. They will provide insight into data trends, identify oppo...

Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions...

The Director of Appeals & Grievances is responsible for leading and directing the activities of the Grievance and Appeals Unit, ensuring member complaints are reviewed and resolved in accordance with...

The Manager, Healthcare Services - Pediatrics is responsible for overseeing and managing a team of healthcare professionals to ensure the delivery of quality care to pediatric patients. This remote po...

Lead Business Analyst, Payment Integrity. Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Constructs forecasts, recom...

Lead Business Analyst, Medicaid Encounters. Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers...

The Mgr, Appeals & Grievances is responsible for leading and directing the activities of the Grievance and Appeals Unit, ensuring compliant resolution of member and provider complaints...

The Engineer, EIS is responsible for building company-specific systems and technology expertise across multiple infrastructure and development disciplines. They contribute to project tasks and deliver...

The Sr Actuarial Analyst (Medicaid Risk Adjustment) is responsible for estimating liabilities, establishing premium rates, financial analysis, and reporting. They analyze data to identify risks and tr...

The Care Review Clinician ABA is responsible for assessing ABA services for members, ensuring compliance with regulations and guidelines, and collaborating with various departments to provide quality...