Knowledge/Skills/Abilities
Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
• Oversees development, organization, and ongoing maintenance of data representing a wide range of healthcare information.
• Develops and directs a process to clean and integrate complex healthcare datasets in order to create the data foundation for further analytics and the development of key insights.
• Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Oversees, establishes, and maintains timelines for reports and projects.
• Ensures quality of output by submitting work product for quality checks and reviews and performing similar functions for other staff..
Job Qualifications
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
3-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years
RN license highly preferred
#LI-AC1
#HTF
#PJCorp
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Knowledge/Skills/Abilities
Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
• Oversees development, organization, and ongoing maintenance of data representing a wide range of healthcare information.
• Develops and directs a process to clean and integrate complex healthcare datasets in order to create the data foundation for further analytics and the development of key insights.
• Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Oversees, establishes, and maintains timelines for reports and projects.
• Ensures quality of output by submitting work product for quality checks and reviews and performing similar functions for other staff..
Job Qualifications
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
3-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years
RN license highly preferred
#LI-AC1
#HTF
#PJCorp
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Knowledge/Skills/Abilities
Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
• Oversees development, organization, and ongoing maintenance of data representing a wide range of healthcare information.
• Develops and directs a process to clean and integrate complex healthcare datasets in order to create the data foundation for further analytics and the development of key insights.
• Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Oversees, establishes, and maintains timelines for reports and projects.
• Ensures quality of output by submitting work product for quality checks and reviews and performing similar functions for other staff..
Job Qualifications
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
3-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years
RN license highly preferred
#LI-AC1
#HTF
#PJCorp
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Knowledge/Skills/Abilities
Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
• Oversees development, organization, and ongoing maintenance of data representing a wide range of healthcare information.
• Develops and directs a process to clean and integrate complex healthcare datasets in order to create the data foundation for further analytics and the development of key insights.
• Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Oversees, establishes, and maintains timelines for reports and projects.
• Ensures quality of output by submitting work product for quality checks and reviews and performing similar functions for other staff..
Job Qualifications
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
3-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years
RN license highly preferred
#LI-AC1
#HTF
#PJCorp
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Knowledge/Skills/Abilities
Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
• Oversees development, organization, and ongoing maintenance of data representing a wide range of healthcare information.
• Develops and directs a process to clean and integrate complex healthcare datasets in order to create the data foundation for further analytics and the development of key insights.
• Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Oversees, establishes, and maintains timelines for reports and projects.
• Ensures quality of output by submitting work product for quality checks and reviews and performing similar functions for other staff..
Job Qualifications
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
3-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years
RN license highly preferred
#LI-AC1
#HTF
#PJCorp
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Knowledge/Skills/Abilities
Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
• Oversees development, organization, and ongoing maintenance of data representing a wide range of healthcare information.
• Develops and directs a process to clean and integrate complex healthcare datasets in order to create the data foundation for further analytics and the development of key insights.
• Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Oversees, establishes, and maintains timelines for reports and projects.
• Ensures quality of output by submitting work product for quality checks and reviews and performing similar functions for other staff..
Job Qualifications
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
3-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years
RN license highly preferred
#LI-AC1
#HTF
#PJCorp
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Knowledge/Skills/Abilities
Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
• Oversees development, organization, and ongoing maintenance of data representing a wide range of healthcare information.
• Develops and directs a process to clean and integrate complex healthcare datasets in order to create the data foundation for further analytics and the development of key insights.
• Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Oversees, establishes, and maintains timelines for reports and projects.
• Ensures quality of output by submitting work product for quality checks and reviews and performing similar functions for other staff..
Job Qualifications
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
3-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years
RN license highly preferred
#LI-AC1
#HTF
#PJCorp
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Knowledge/Skills/Abilities
Registed Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
• Oversees development, organization, and ongoing maintenance of data representing a wide range of healthcare information.
• Develops and directs a process to clean and integrate complex healthcare datasets in order to create the data foundation for further analytics and the development of key insights.
• Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Oversees, establishes, and maintains timelines for reports and projects.
• Ensures quality of output by submitting work product for quality checks and reviews and performing similar functions for other staff..
Job Qualifications
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
3-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years
RN license highly preferred
#LI-AC1
#HTF
#PJCorp
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Come join us for our upcoming virtual hiring event!
Event Date & Time: Tuesday, June 9th at 12:00pm EST Register here today: Molina Healthcare Florida Virtual Hiring Event 1
Event Date & Time: Thursday, June 25th at 12:00pm EST Register here today: Molina Healthcare Florida Virtual Hiring Event 2
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 contributes to overarching strategy to provide quality and cost-effective member care.
Must reside in the following counties:
Region A: Escambia, Santa Rosa, Washington, Gadsden, Leon, Bay, Okaloosa, Walton, Wakulla, Jackson, Jefferson, Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, Washington Region B: Duval, Hernando, Lake, Marion, Volusia, Alachua, Columbia, St. Johns, Flagler, Citrus, Suwannee, Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dizie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St John's, Sumter, Suwannee, Union, Volusia Region C: Pasco, Pinellas Region D: Hardee, Highlands, Hilssborough, Manatee, Polk - but highest volumes to be in Hillsborough, Manatee, and Polk Region E: Seminole, Orange, Osceola, Brevard Region F: Charlotte, Collier, Desoto, Glades, Hendry, lee, Sarasota) - but highest volumes to be in Collier, Lee, and Hendry Region G: Indian River, Martin, Okeechobee, Palm Beach, and St Lucie )- but highest volumes in Palm Beach, St Lucie, Indian River, and Martin Region H: Broward Region I: Miami-Dade, Monroe
Essential Job Duties
• Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments.
• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• Collaborates with licensed care managers/leadership as needed or required.
• 25- 40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
Preferred Qualifications
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
#PJHS
#HTF
#LI-AC1
Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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 contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive behavioral health assessments of members per regulated timelines and determines who may qualify for care coordination/case management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.
• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate healthcare professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• May provide consultation, resources and recommendations to peers as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years health care experience, preferably in behavioral health, or equivalent combination of relevant education and experience.
• Licensed behavioral health clinician to include: Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT, Doctor of Psychology (PhD or PsyD) or equivalency based on state contract, regulation, or state board licensing mandate. If licensed, license must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Experience with working with persons with severe and persistent mental health concerns and serious emotional disturbances, to include substance use disorder and foster care.
• Knowledge and experience related to whole person care principles, chronic health conditions, and discharge planning coordination.
• Data entry skills and previous experience utilizing a clinical platform.
• Excellent verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Certified Case Manager (CCM).
• Experience in behavioral health care management.
• Field-based care management or home health experience.
#PJHS
#LI-AC1
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $26 - $42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
