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Careers at hckd.fa.us2.oraclecloud.com
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600 positions at hckd.fa.us2.oraclecloud.com
(RN)Care Manager - Nevada Based
hckd.fa.us2.oraclecloud.com·Las Vegas, NV, 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 contri…
Remote Care Review Clinician- Utilization Review- NV RN license req.
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach de…
Intensive Care Manager- Behavioral Health License (Horry Cnty- Local Travel Req.)
hckd.fa.us2.oraclecloud.com·Myrtle Beach, SC, 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 contri…
Specialist, IRIS Consulting (Fond du Lac County, WI)
hckd.fa.us2.oraclecloud.com·Fond du Lac, WI, United States
JOB DESCRIPTION Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for so…
Investigator, Special Investigative Unit-Nebraska
hckd.fa.us2.oraclecloud.com·NE, United States
JOB DESCRIPTION Job Summary Provides investigative support for special investigation unit (SIU) activities. Responsible for supporting for the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse …
Representative, Health Plan Provider Relations (( Wisconsin long-term services and supports (LTSS) Provider Quality; must reside in Wisconsin)
hckd.fa.us2.oraclecloud.com·Wisconsin Rapids, WI, United States
JOB DESCRIPTION Job Summary Position collaborates daily with LTSS providers to include Adult Family Homes, Assisted Livings, Adult Day Care Centers, Ancillary Providers, and Nursing Homes in review of potential concerns in quality-of-service delivery to MCW members. Ensures prov…
Program Manager (Claims - MST hours)
hckd.fa.us2.oraclecloud.com·Albuquerque, NM, United States
JOB DESCRIPTION Job Summary Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playboo…
Field Care Manager, LTSS (LVN) - Local Travel Required
hckd.fa.us2.oraclecloud.com·San Benito, TX, United States
JOB DESCRIPTION Opportunity for a Texas licensed LVN to join Molina as a Field Care Manager to work with our Medicaid members in the San Benito, TX serviced delivery area. You will complete assessments needed for determining the types of services the non-waiver members are elig…
Field Care Manager, LTSS (RN) - Local Travel Required
hckd.fa.us2.oraclecloud.com·Harlingen, TX, United States
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina as a Field Care Manager to work with our Medicaid members in the Harlingen, TX serviced delivery area. You will complete assessments needed for determining the types of services the waiver members are eligible to…
Field Care Manager, LTSS (RN) - Local Travel Required
hckd.fa.us2.oraclecloud.com·Mission, TX, United States
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina as a Field Care Manager to work with our Medicaid members in the Mission, TX serviced delivery area. You will complete assessments needed for determining the types of services the waiver members are eligible to r…
Field Care Manager, LTSS (RN) - Local Travel Required
hckd.fa.us2.oraclecloud.com·Beach City, TX, United States
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina as a Field Care Manager to work with our Medicaid members in the service delivery area in and around Baytown, Beach City, Highlands, Channelview, and La Porte, TX. You will complete assessments needed for determi…
Field Care Manager, LTSS (RN) - Local Travel Required
hckd.fa.us2.oraclecloud.com·Cockrell Hill, TX, United States
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina to work with our Medicaid members in the greater Dallas neighborhoods of Westmoreland Heights and Cockrell Hill service delivery area. You will conduct face-to-face visits with members in their homes, completing …
Field Care Manager, LTSS (LVN) - Local Travel Required N/NE Dallas
hckd.fa.us2.oraclecloud.com·Dallas, TX, United States
JOB DESCRIPTION Opportunity for a Texas licensed LVN to join Molina to work with our Medicaid members in the greater Dallas neighborhoods of Old East Dallas, Dolphin Heights, South Dallas service delivery area. You will conduct face-to-face visits with members in their homes, co…
Telephonic Care Manager, LTSS (RN)
hckd.fa.us2.oraclecloud.com·TX, United States
JOB DESCRIPTION Opportunity for a TX licensed RN, residing in Texas, with experience functioning as a Care Manager working with Complex/Intensive cases assisting with Disease Management. Telephonically you will complete assessments needed for determining the types of services we…
VP, Network Management (Illinois)
hckd.fa.us2.oraclecloud.com·Downers Grove, IL, United States
JOB DESCRIPTION Job Summary Provides executive strategy and leadership to team responsible for network operations and contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Also responsible f…
Nurse Practitioner, Behavioral Health UM (PMHNP)- PST
hckd.fa.us2.oraclecloud.com·United States
Job Description Job Summary Performs behavioral health utilization reviews, applying evidence-based criteria, and collaborating with physicians to ensure clinically appropriate, cost-effective, and regulatory-compliant care determinations. Assists in evaluating medical necess…
Field Care Manager, LTSS (RN) - IDD Experience Required - Local Travel
hckd.fa.us2.oraclecloud.com·Houston, TX, United States
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina to work with our IDD members in the Houston service delivery area. Our Care Managers conduct face-to-face meetings with the members in their homes, completing assessments needed to determine the types of services…
Health Plan Provider Contracts Manager (Directed Payment Programs) - TX ONLY
hckd.fa.us2.oraclecloud.com·TX, United States
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for health plan provider network complex contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Responsible for n…
Care Review Clinician (RN) - Reside in PST
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Candidates must reside in the Pacific Standard Time (PST) zone. The standard work schedule is 8:30 AM to 5:00 PM, with a rotating weekend requirement approximately every 7–9 weeks, which may include working a full weekend or a single weekend day. Prior author…
Lead, Medicare Administration (Remote)
hckd.fa.us2.oraclecloud.com·United States
Molina Healthcare is hiring a Lead, Medicare Administration. This will be a remote position on our team that is responsible for our Medicare product- both Bids and Member Materials. Highly qualified candidates will have the following experience: • Medicare experience …
Field Nurse Practitioner (Victorville, CA)
hckd.fa.us2.oraclecloud.com·Victorville, CA, 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…
Field Patient Care Delivery (San Diego, CA)
hckd.fa.us2.oraclecloud.com·San Diego, CA, United States
Job Description Job Summary The Specialist, Patient Care Delivery is a multi-disciplinary healthcare professional who delivers high-quality, compassionate care to health plan members in their homes. This role combines clinical expertise, cultural sensitivity, and excellent …
Senior Analyst, Healthcare
hckd.fa.us2.oraclecloud.com·Edinburg, TX, United States
Knowledge/Skills/Abilities Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment …
Chief Medical Officer, Health Plan (Based in IL)
hckd.fa.us2.oraclecloud.com·Downers Grove, IL, United States
JOB DESCRIPTION Job Summary Provides executive level strategy and leadership to the health plan in the development and execution of care management and utilization management programs. Develops clinical practice guidelines and oversees appropriateness and medical necessity of ser…