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299 positions at hckd.fa.us2.oraclecloud.com
Program Manager, Medicare Stars & Quality Improvement (Remote in South Carolina Health Plan)
hckd.fa.us2.oraclecloud.com·SC, United States
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiatives and education programs to support improved Medicare Sta…
Program Manager, Medicare Stars & Quality Improvement (Remote in Texas)
hckd.fa.us2.oraclecloud.com·TX, United States
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiatives and education programs to support improved Medicare Sta…
Sr Data Analyst, Enrollment Research and Data Analytics (Remote)
hckd.fa.us2.oraclecloud.com·United States
Molina Healthcare is hiring for a Sr Data Analyst, Enrollment Research and Data Analytics. This role is a Senior Data Analyst on our Research & Analytics team that supports enrollment operations. We work with member and enrollment data across lines of business like Medicaid, Med…
Senior Program Manager ( Network Performance and Effectiveness)
hckd.fa.us2.oraclecloud.com·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…
Sr Quality Improvement, HEDIS Spec, Health Plan Interventions (Remote In Ohio)
hckd.fa.us2.oraclecloud.com·Columbus, OH, United States
Molina Healthcare of Ohio is hiring for a Sr Quality Improvement/HEDIS Specialist on our Health Plan Community Interventions team. This role is remote however candidates must live in Ohio. This role is laser focused on Quality Improvement using QI Science. This role will be …
Community Connector (In Field Travel in Jackson, Harrison, Hancock, Stone, Pearl River) - MS ONLY
hckd.fa.us2.oraclecloud.com·Biloxi, MS, 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 …
Lead Analyst, Provider and Facility Reimbursement (Remote)
hckd.fa.us2.oraclecloud.com·United States
Molina Healthcare is hiring for a Lead Analyst that will handle Provider and Facility Reimbursements. This team has oversight for all lines of business within our facility reimbursement scope. This team mixes some technical knowledge with operational oversight. Operational knowl…
Care Manager (BH Licensed) (Must Reside in Mississippi)
hckd.fa.us2.oraclecloud.com·Mississippi City, MS, 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…
Director, Value-Based Programs (Remote in FL)
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Leads and directs team responsible for value-based programs (VBP) activities. Responsible for developing and implementing value-based strategies for lines of business impacted by the regulatory risk adjustment payment model. Supports achievement of fi…
RN Health Home Care Coordinator -Hybrid Lewis County, WA
hckd.fa.us2.oraclecloud.com·Centralia, WA, United States
JOB DESCRIPTION The role typically begins with a training period, during which the employee works closely with a Care Coordinator within their assigned region. Upon completion of training, the employee is provided with an outreach list of 100 members. Care Coordinators gradual…
Program Manager (MMISR - MST hours)
hckd.fa.us2.oraclecloud.com·Albuquerque, NM, United States
JOB DESCRIPTION Job Summary Provides support to Molina MMISR IT areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion n…
Program Manager (Vendor Operations - MST hours)
hckd.fa.us2.oraclecloud.com·Albuquerque, NM, United States
JOB DESCRIPTION Job Summary Provides support to Molina Vendor Operations through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champio…
Representative, Hospital Health Plan Provider Relations (FL)
hckd.fa.us2.oraclecloud.com·FL, United States
Description for Internal Candidates JOB DESCRIPTION ***This role will support hospital providers throughout Florida*** Job Summary Provides support for health plan hospital provider relations activities. Supports network development, network adequacy …
Manager, Hospital Health Plan Provider Contracts
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION *****Employee for this role must reside in Florida***** Job Summary Leads and manages team responsible for Hospital Health Plan provider network contracting activities. Supports network strategy and development with respect to adequacy, financial performance a…
Product Owner - HEDIS Engine / Clinical Data (Remote)
hckd.fa.us2.oraclecloud.com·United States
Job Description Job Summary Provides subject matter expertise in the delivery, execution and maintenance of products. Accountable for maximizing the value of assigned technical products that support enterprise operations. Owns the product vision, backlog, and delivery outcomes …
Director, Projects (PMP Certification)
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Ideal Candidate will have a Project Management Professional (PMP) certification. Job Summary Manages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering prod…
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…
Community Connector - Must live in OH
hckd.fa.us2.oraclecloud.com·Lima, OH, United States
This is a remote field-based role requiring daily travel. Job Summary Provides 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 member…
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…