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Careers at hckd.fa.us2.oraclecloud.com
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594 positions at hckd.fa.us2.oraclecloud.com
Remote DRG Clinical Validation Reviewer (Coding RN)
hckd.fa.us2.oraclecloud.com·United States
Job Description Job Summary Performs focused clinical reviews of inpatient and outpatient claims to verify that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies accurately reflect the patient’s documented clinical condition, services ren…
Representative, Health Plan Provider Relations
hckd.fa.us2.oraclecloud.com·Waltham, MA, United States
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 netw…
Director, Health Plan Provider Contracts (Nevada)
hckd.fa.us2.oraclecloud.com·NV, United States
JOB DESCRIPTION Job Summary Leads and directs team responsible for health plan provider network contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Collaborates with senior leadership and …
Auditor, Compliance (Remote in FL)
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Provides support for compliance auditing activities. Responsible for evaluating Molina's adherence to regulatory requirements, internal policies, and health care industry standards by identifying compliance gaps and recommending improvements to mitigate risk re…
Senior Specialist, PSOC / Physical Security Systems (Remote)
hckd.fa.us2.oraclecloud.com·United States
Job Summary: Provides senior level support for Molina Physical Security enterprise applications. Responsible for executing and managing the applications that support physical security operations, emergency response, and health and safety across the Molina enterprise. Implements…
Specialist, Appeals & Grievances
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers …
Associate General Counsel
hckd.fa.us2.oraclecloud.com·United States
***Remote and must live in the United States*** Job Description Job Summary Provides associate level support for legal counsel activities. Provides legal advisement related to rights, obligations, and privileges of the organization. Partners closely with legal and business sta…
Analyst, Pharmacy Data & Analytics
hckd.fa.us2.oraclecloud.com·United States
Job Description Job Summary Designs and implements reports and analyses to help the business team make informed decisions and meet regulatory requirements. Offers insight into key business problems and deliverables by applying statistical analysis techniques to examine structur…
Associate Representative, Health Plan Provider Relations - Remote must reside in UT
hckd.fa.us2.oraclecloud.com·UT, United States
JOB DESCRIPTION Job Summary *Must go to field as needed* Provides entry level 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 c…
Medical Director (New York)
hckd.fa.us2.oraclecloud.com·New York, NY, United States
JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for both members and providers and ensuring members receive the most appropriate c…
CSR Medication Therapy Management Services Bilingual Mandarin or Spanish (Remote)
hckd.fa.us2.oraclecloud.com·United States
Molina Healthcare is hiring for a CSR for our Medication Therapy Management department. This role will be working Monday through Friday 10am to 630pm Mountain Standard Time. Highly qualified candidates will have exceptional customer service skills, great skills navigating Win…
Senior Specialist, Government Contracts (MA State Health Plan)
hckd.fa.us2.oraclecloud.com·Boston, MA, United States
JOB DESCRIPTION Job Summary Provides senior level support for government regulatory contracts activities. Responsible for the development and administration of contracts with state and/or federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored pro…
Senior Program Manager - Must Reside in KY (Regulatory/Legal Experience Preferred)
hckd.fa.us2.oraclecloud.com·KY, United States
JOB DESCRIPTION Job Summary Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Mo…
Account Representative, Medicare Sales-Des Moines-Iowa
hckd.fa.us2.oraclecloud.com·Des Moines, IA, United States
JOB DESCRIPTION Job Summary Provides support for Molina Medicare sales activities. Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare-Medicaid recipients within market areas to achieve revenue, profitab…
Community Connector - East-Central OH
hckd.fa.us2.oraclecloud.com·Coshocton, OH, United States
JOB DESCRIPTION Job SummaryProvides support for community-based member advocacy activities. Serves as a local member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing health care needs. Contributes …
Supervisor, Configuration Oversight (Payment Integrity Claims Audit)
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Leads and supervises team responsible for configuration oversight activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan…
Care Manager, LPN/LVN - MIAMI, FL
hckd.fa.us2.oraclecloud.com·Miami, FL, United States
Come join us for our upcoming virtual hiring event! Event Date & Time: Tuesday July 14th at 12:00pm EST Register here today: Florida Care Managers (Miami) & Care Review Clinicians Virtual Hiring Event Event Date & Time: Thursday, July 23rd at 12:00pm EST Register here today: Fl…
Care Manager (BH Licensed: RN, LCSW, LMHC, LMFT, LMSW) in MIAMI, FL
hckd.fa.us2.oraclecloud.com·Miami, FL, United States
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contribu…
(LVN/LPN)-Transition of Care Coach (Nevada Based)
hckd.fa.us2.oraclecloud.com·Las Vegas, NV, United States
JOB DESCRIPTION Job Summary Provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from hospital admission to all other settings. Strives to ensure that best possible services are available to members at t…
Field Nurse Practitioner (Tacoma, WA)
hckd.fa.us2.oraclecloud.com·Tacoma, WA, United States
JOB DESCRIPTION Job Summary Provides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel most comfortable, including in-home, community and nursing facilities and “pop up” clinics. Strives to ensure memb…
Health Plan Provider Relations Manager (Remote in IL)
hckd.fa.us2.oraclecloud.com·IL, United States
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership 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 …
Care Management Processor - Must live in IA
hckd.fa.us2.oraclecloud.com·Sioux City, IA, United States
Job Summary Provides non-clinical administrative support to the care management function, and contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-e…
Analyst, Health Plan Risk & Quality Reporting (Remote)
hckd.fa.us2.oraclecloud.com·Miami, FL, United States
JOB DESCRIPTION Job Summary Provides analyst support for health plan risk and quality reporting activities. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of initiatives. Educates users on how to use reports…
Senior Analyst, National Quality Analytics & Performance - Medicare Star Reporting (Remote)
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides senior level analyst support for Molina enterprise risk and quality reporting activities. Designs and develops reporting solutions to support Healthcare Effectiveness Data and Information Set (HEDIS) auditing, rate tracking, identification o…