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Careers at hckd.fa.us2.oraclecloud.com
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594 positions at hckd.fa.us2.oraclecloud.com
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…
Care Review Clinician (RN) - Remote in FL
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Must reside in Florida 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 - …
Care Review Clinician (BH Licensed) - Remote in FL
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations, and ensur…
Transition of Care Coach (RN-Peds) - Miami, FL
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Candidates must reside in Florida and hold an active, unrestricted nursing license in the state. This is a hybrid position requiring approximately 20% travel to hospital settings to support member needs. Applicants must have a minimum of two years of case manage…
Peer Specialist - CRPS Required-Hillsborough County Florida
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job SummaryProvides peer support services for members with behavioral health needs/chemical dependency issues. In collaboration with multidisciplinary care team working across the continuum, strives to ensure member progress toward desired outcomes, and contribute…
Care Manager (BH Licensed)
hckd.fa.us2.oraclecloud.com·KY, 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…
Representative, Support Center
hckd.fa.us2.oraclecloud.com·KY, United States
JOB DESCRIPTION Job Summary Provides level I support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, and…
Program Manager, Healthcare Services (Clinical Policy and Medicare Compliance)
hckd.fa.us2.oraclecloud.com·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, po…
AVP, Health Plan Operations
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides strategy and leadership to team responsible for the development and administration of state health plan operational functions, programs and services - ensuring functional operations, contractual compliance, and alignment with health plan memb…
Field Care Manager, LTSS (RN) - Local Travel Required
hckd.fa.us2.oraclecloud.com·Dallas, TX, United States
JOB DESCRIPTION Opportunity for Texas licensed RN to join Molina as a Care Manager working with our Medicaid members in the Dallas, TX service delivery area. If hired, you will conduct face-to-face meetings with the members in their homes, completing assessments needed for dete…
Care Manager (RN- Remote with Mass based travel req)
hckd.fa.us2.oraclecloud.com·Dorchester, MA, United States
JOB DESCRIPTION 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 continuum for members with high-need pot…
Analyst, Claims Research (Must reside in Florida)
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and…
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 Engineer, Big Data
hckd.fa.us2.oraclecloud.com·United States
Job Description Job Summary We are seeking a highly skilled and experienced Sr Big Data Engineer to drive enterprise architecture strategy, platform engineering, modernization initiatives, and end-to-end solution delivery. This role will lead data and analytics transformation…
Lead Analyst, Claims COB Audit
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides lead level support for COB-specific claim pricing audits. Responsible for accurate and timely implementation and maintenance of critical information on claims/provider databases, validating data housed on databases and ensuring adherence to b…
Specialist, Appeals & Grievances (Must Reside in OH or KY)
hckd.fa.us2.oraclecloud.com·OH, 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 …
Manager, Health Plan Member & Community Interventions
hckd.fa.us2.oraclecloud.com·Jackson, MS, United States
JOB DESCRIPTION ****Employee for this role must reside in Mississippi**** Job Summary Leads and manages team responsible for clinical quality member intervention activities. Responsible for the developing and implementing new and existing member intervention initiatives inclu…
AVP, Data & Analytics - Clinical informatics/Risk and Quality - Remote
hckd.fa.us2.oraclecloud.com·United States
Summary: Direct comprehensive data and analytics initiatives to enhance payer strategy, operational excellence, and clinical outcomes across Medicare, Medicaid, and Commercial populations. Oversee enterprise reporting, integrate pragmatic AI/ML solutions, and specialized clinica…
Manager, Health Plan Provider Contracts (Value-Based Contracts)
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Molina Health Plan Provider Network Contracting jobs are responsible for the value-based payments (VBP) network strategy and development with respect to financial performance and operational performance, in alignment with Molina Healthcare's overall m…
Lead, Core Operations (Must reside in Florida)
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides lead level support for core operations activities including claims processing, benefit interpretation, provider services, provider enrollment, etc., ensuring functional operations and contractual compliance. Essential Job Duties • Effectiv…
Field Nurse Practitioner (Boise, ID)
hckd.fa.us2.oraclecloud.com·Boise, ID, 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…
Care Manager, LTSS
hckd.fa.us2.oraclecloud.com·Madison, WI, United States
***Remote with travel throughout Dane County, WI for member visits*** JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrate…
IRIS Self-Directed Personal Care (RN) (Milwaukee County, WI)
hckd.fa.us2.oraclecloud.com·Milwaukee, 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 liv…
Care Manager, LTSS
hckd.fa.us2.oraclecloud.com·Eau Claire, WI, United States
***Remote with travel throughout Chippewa & Eau Claire Counites, WI for member visits*** JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coo…