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Careers at hckd.fa.us2.oraclecloud.com
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600 positions at hckd.fa.us2.oraclecloud.com
Investigator, Special Investigative Unit Coding-Miami Florida
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud and abuse investigations of medical providers using informat…
Investigator, Special Investigative Unit-must reside in Florida
hckd.fa.us2.oraclecloud.com·FL, 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 …
Program Manager, Healthcare Services (Enhanced Care Mgmt - PST hours)
hckd.fa.us2.oraclecloud.com·CA, United States
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, poli…
Account Representative, Medicare Sales-LA-Fully bilingual-Spanish
hckd.fa.us2.oraclecloud.com·Los Angeles, CA, 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…
Care Management Processor (Must reside in Michigan)
hckd.fa.us2.oraclecloud.com·MI, United States
JOB DESCRIPTION Job SummaryProvides 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 qual…
Housing Specialist (Must Reside in Florida)
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides support for member housing and placement activities, including assisting members at risk of homelessness and members recently discharged from institutions with permanent housing options. Also promotes member self-sufficiency and integration i…
Community Connector (CHW or LPN) Must be near Zanesville OH
hckd.fa.us2.oraclecloud.com·Zanesville, 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 …
AVP, Maternal Child Health Clinical Operations - REMOTE
hckd.fa.us2.oraclecloud.com·United States
Job Summary The AVP of Maternal & Child Clinical Operations provides strategic leadership and operational oversight for enterprise-wide maternal, newborn, and child health programs. This leader ensures high-quality, equitable, evidence-based care management programs across peri…
Supervisor, Claims (Must reside in FL)
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Leads and supervises team responsible for claims activities including administering claims payments, maintaining claim records, and providing counsel to Providers regarding coverage amount and benefit interpretation. Also monitors and controls backlog…
Care Manager, LTSS (RN) - Field travel in Iowa and Richland County, WI
hckd.fa.us2.oraclecloud.com·Dodgeville, WI, United States
JOB DESCRIPTION Family Care with My Choice Wisconsin Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the …
Specialist, Facility Site Review (must reside in California)
hckd.fa.us2.oraclecloud.com·Los Angeles, CA, United States
Job Description Job Summary Provides support for facility site review activities including routine document preparation and file management, site review meeting/travel scheduling, and office supply ordering. Facilitates activities including training and reporting, and supports …
Care Management Processor (Must reside in Michigan)
hckd.fa.us2.oraclecloud.com·MI, United States
JOB DESCRIPTION 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 …
Director Core Systems Strategies - QNXT/NetworX - Remote
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Leads and directs team responsible for configuration 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 business and …
Manager, Healthcare Analytics - AI/Databricks - Remote
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to provider networks and other end users for operational and strategic analysis.…
Senior Data Analyst
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION This role will be a member of the Payment Integrity Analytics team who is responsible for creating and maintaining a post pay review of claims, members, and providers to ensure accurate billing. Our team creates Post Pay Concepts (Analytics) that identify inaccur…
Manager, Data Analytics
hckd.fa.us2.oraclecloud.com·United States
Job Description Job Summary Manages the activities of the Data Analytics and Reporting team. Performs research and analysis of complex Clinical Data - Utilization & Care Management Data. Evaluates, writes, and presents reports and makes recommendations based on relevant finding…
Senior Health Educator- Clinical Transplant Nurse- Remote
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides senior level support for health education activities. Responsible for developing, implementing, and maintaining health plan health education programs. Assists in identifying health education program needs, researching and developing health ed…
Senior Health Educator- Substance Use / Addiction and Recovery- Remote
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides senior level support for health education activities. Responsible for developing, implementing, and maintaining health plan health education programs. Assists in identifying health education program needs, researching and developing health ed…
Senior Health Educator- Pediatric Mental Health Nurse - Remote
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides senior level support for health education activities. Responsible for developing, implementing, and maintaining health plan health education programs. Assists in identifying health education program needs, researching and developing health ed…
Senior Health Educator- Asthma Educator - Remote
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides senior level support for health education activities. Responsible for developing, implementing, and maintaining health plan health education programs. Assists in identifying health education program needs, researching and developing health ed…
Senior Analyst, Risk & Quality Reporting - HEDIS
hckd.fa.us2.oraclecloud.com·AZ, United States
Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina’s Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educate…
Auditor, Provider Network (Queens, NY: Social Adult Daycare Centers)
hckd.fa.us2.oraclecloud.com·Queens, NY, United States
Job Description ****90% of this role will travel throughout NYC to conduct on-site audits, complaint investigations, and regulatory reviews in order to meet oversight and compliance requirements*** Job Summary Provides audit support for contractual and regulatory compliance fo…
Senior Health Educator- Pediatric Oncology/Hematology - Remote
hckd.fa.us2.oraclecloud.com·FL, United States
Job Description Job Summary The Sr Health Educator is responsible for developing, implementing, and maintaining Health Plan Health Education programs. Oversees and assists providers in meeting health education contract requirements and serves as a resource for other Health Edu…
(RN)Auditor, Healthcare Services - NCQA
hckd.fa.us2.oraclecloud.com·NM, United States
JOB DESCRIPTION Job Summary Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching stra…