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Careers at hckd.fa.us2.oraclecloud.com
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594 positions at hckd.fa.us2.oraclecloud.com
Analyst, Data & Analytics (Must reside in CA)
hckd.fa.us2.oraclecloud.com·Long Beach, CA, United States
Job Description Job Summary Provides support in conducting research, analysis, and reporting across healthcare and operational data to support decision‑making, cost‑containment strategies, and business performance improvement. Works with complex datasets including claims, pharm…
Specialist, Provider Appeals (Florida)
hckd.fa.us2.oraclecloud.com·FL, 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 …
Senior Program Manager, Medicare Stars & Quality Improvement
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides deep subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Plans and implements QI initiatives and education programs to support improved Medicare Star ratings. Responsible for leading and…
Senior Program Manager, Medicare Stars & Quality Improvement
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides deep subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Plans and implements QI initiatives and education programs to support improved Medicare Star ratings. Responsible for leading and…
AVP, Health Plan Quality & Risk Adjustment (Nevada)
hckd.fa.us2.oraclecloud.com·NV, United States
JOB DESCRIPTION Job Summary Provides strategy and leadership to team responsible for health plan risk and quality activities. Oversees health plan execution for risk and quality, including alignment with enterprise quality strategy. Interfaces with regulatory agencies, leads loca…
Specialist, IRIS Eligibility Screening (Milwaukee County, WI)
hckd.fa.us2.oraclecloud.com·Milwaukee, WI, United States
JOB DESCRIPTION Job Summary Job Summary TMG is on the lookout for our next great Eligibility Screener! If you love doing meaningful work that helps others live their best lives, we want to hear from you! We’re currently in search for someone with a background in human ser…
IRIS Self-Directed Personal Care (RN) (Dane County, WI)
hckd.fa.us2.oraclecloud.com·Madison, WI, United States
Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives …
Care Manager, LTSS (RN) - Field travel in Milwaukee County, WI
hckd.fa.us2.oraclecloud.com·Milwaukee, WI, United States
JOB DESCRIPTION Partnership with My Choice Wisconsin Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across t…
Care Manager (RN) (Behavioral Health) Must live in AZ
hckd.fa.us2.oraclecloud.com·Phoenix, AZ, United States
JOB DESCRIPTION This RN will act as a Care Manager supporting our AZ Medicaid members who have recently been admitted to this hospital. The Medicaid Care Manager will support them to ensure a successful transition from inpatient to discharge to either a post acute care or back t…
Associate Program Manager, Process & Performance Monitoring, Managed Care (Remote in FL Preferred)
hckd.fa.us2.oraclecloud.com·FL, United States
Molina Healthcare is hiring several Associate Program Managers in our Government Contracts division. Associate program managers will be responsible for ensuring services, issue resolution, organization, communication, and cross-functional collaboration for a specific set of memb…
Senior Specialist, Coding (Remote)
hckd.fa.us2.oraclecloud.com·United States
Job Description: The Senior Specialist, Coding Research supports Payment Integrity Prepay operations by researching correct coding edit inquiries, analyzing edit outcomes, validating coding rationale, and monitoring savings and accuracy trends within assigned scope. This …
Program Manager, Medicare Stars & Quality Improvement (Remote in Idaho)
hckd.fa.us2.oraclecloud.com·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…
Care Manager, LTSS (RN) (Bilingual Spanish) - Field travel in Milwaukee County, WI)
hckd.fa.us2.oraclecloud.com·Wauwatosa, WI, United States
JOB DESCRIPTION Family Care with My Choice Wisconsin This opening is for a Bilingual Spanish speaking RN. Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team co…
Manager, National Provider Services
hckd.fa.us2.oraclecloud.com·United States
***Remote and must live in the United States*** JOB DESCRIPTION Job Summary Leads and manages team responsible for enterprise network management and operations activities including network development, network adequacy, and provider training and education. Serves as primary p…
Field Care Manager, LTSS (RN) - Local Travel Required
hckd.fa.us2.oraclecloud.com·Fort Worth, TX, United States
JOB DESCRIPTION Opportunity for TX RN to join Molina as a Care Manager working with our Medicaid members in Fort Worth in neighborhoods surrounding the zoo. Responsibilities include completing in-home, face-to-face assessments with our waiver Medicaid members there. Preference w…
Auditor, Healthcare Services (Remote in MI)
hckd.fa.us2.oraclecloud.com·Detroit, MI, United States
JOB DESCRIPTION This position will offer remote work flexibility, but the selected candidate must reside in Michigan. Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical Auditor. The person filling this role will be an instrumen…
Medical Director (Medicare/Appeals)
hckd.fa.us2.oraclecloud.com·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 ca…
Senior Program Manager, Medicare Stars & Quality Improvement
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides deep subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Plans and implements QI initiatives and education programs to support improved Medicare Star ratings. Responsible for leading an…
National Quality Performance Manager (Remote)
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides subject matter expertise for Molina’s risk and quality performance solutions (RQS) team. Collaborates with various departments and stakeholders across the enterprise to plan, coordinate, and manage resources, and execute quality and risk perfo…
Director, Value-Based Programs
hckd.fa.us2.oraclecloud.com·United States
***Remote and must live in the 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 a…
Care Manager, LTSS (RN) Remote (Detroit MI)
hckd.fa.us2.oraclecloud.com·Detroit, MI, United States
JOB DESCRIPTION This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been admitted to this hospital. The Medicaid will support them to ensure a successful transition from inpatient to discharge to either a nursing facility or back to thei…
Senior Representative, Health Plan Provider Relations - Remote Must reside in NE
hckd.fa.us2.oraclecloud.com·NE, United States
JOB DESCRIPTION Job Summary Provides senior 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 contracted providers within th…
Care Review Clinician (RN) Remote
hckd.fa.us2.oraclecloud.com·Mid Florida, FL, United States
JOB DESCRIPTION This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been admitted to this hospital. The Medicaid will support them to ensure a successful transition from inpatient to discharge to either a nursing facility or back to the…
Care Manager, LTSS - Field travel in Kenosha County, WI
hckd.fa.us2.oraclecloud.com·Kenosha, 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 (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across t…