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Careers at hckd.fa.us2.oraclecloud.com
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594 positions at hckd.fa.us2.oraclecloud.com
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…
Specialist, Health Plan Provider Engagement
hckd.fa.us2.oraclecloud.com·Seattle, WA, United States
JOB DESCRIPTION Job Summary Provides support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes. Uses a consultative approach, emphasizing physician engagement and behavior change through action…
Care Manager, LTSS - Field travel in Walworth County, WI
hckd.fa.us2.oraclecloud.com·Elkhorn, 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…
Remote Medical Review Nurse (LVN/LPN)- PST schedule
hckd.fa.us2.oraclecloud.com·United States
Job Description Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; v…
Senior Medical Records Collector - Hybrid (Must reside in San Diego, CA)
hckd.fa.us2.oraclecloud.com·San Diego, CA, United States
JOB DESCRIPTION Job SummaryProvides senior level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) speci…
RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
hckd.fa.us2.oraclecloud.com·CA, 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 des…
Program Director - Home Health Coordinator Planning Office (Florida Health Plan) - Remote in Florida
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Position Summary The Program Director for the Home Health Coordinator Planning Office is responsible for leading (1) operational planning and coordination, (2) financial management, (3) regulatory communications and compliance, and (4) overall performance and ex…
AVP, Data Science & Analytics - Top Tech Distinguished Engineer - Remote
hckd.fa.us2.oraclecloud.com·United States
Job Description Job Summary Lead data science and analytics initiatives to drive strategic decision-making and operational efficiency. Oversee the development and implementation of data models, ensuring data integrity and accuracy. Provide actionable insights through comprehens…
Care Manager, LTSS (RN) - Field travel in Grant, Iowa, Green County, WI
hckd.fa.us2.oraclecloud.com·Platteville, WI, United States
JOB DESCRIPTION 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 the continuum for members with high-need…
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…