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.
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, business operating model, 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).
#PJHS
#LI-AC1
#HTF
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: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Job Summary
Provides support and subject matter expertise for clinical pediatric pharmacy services and support. Contributes to overarching clinical pediatric pharmacy strategy for optimization of clinical and medication-related health care outcomes, and quality cost-effective member care.
Essential Job Duties
• Provides clinical pediatric rounds support including examination of member medical records, comprehensive medication reviews, and communication with Health Care Services leadership and nurse case managers who provide outbound support to members and providers
• Support clinical case referrals from Health Care Services/nurse case managers through reviews of member medication profiles and applyingevidence-based medicine and national guidelines when creating recommendations for health care providers for optimization of member medication regimens.
• Analyzes and reviews medication lists for potential patient safety issues, including drug interactions, suboptimal medication regimens, etc in both clinical pediatric rounds and clinical case referral support.
• Promotes clinically appropriate prescribing practices based on evidence-based medicine and national guidelines through various modalities (provider/plan profiling, member drug profile reviews, medication protocols/criteria, and case-by-case interventions).
• Conducts training as needed to Health Care Services leadership/nurse case managers on self-serve pharmacy resources (formulary lookup, pharmacy locator, etc) as well as articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed.
• Researches, develops, and implements drug utilization and disease state management strategies and intervention techniques to deliver high quality, cost effective health care.
• Assists Health Care services leadership and nurse case managers in coordination of care for pharmacy-related issues as nurse case managers provide the necessary outbound health plan service support to members, their caregivers, and providers.
• Serves as a pediatric drug information resource to pharmacy staff, Health Plan Chief Medical Officer, and Health Plan Health Care Services/nurse case manager staff
• Reviews and analyzes clinical reports generated internally or through external Pharmacy Benefit Manager (PBM) to track general clinical trends in drug utilization and identify potential clinical trend issues to be addressed
• Works with Healthcare Services team (e.g., data managers, care managers, etc.) on member-centered interdisciplinary teams.
• Assists leadership in developing/updating policies and procedures, and implementing changes to comply with state and federal regulations.
Required Qualifications
• Doctor of Pharmacy (PharmD). Resident of Florida with active Florida License must be active and unrestricted in applicable state(s) of practice.
• Demonstrated knowledge and expertise in clinical pharmacology and disease management for pediatric populations.
• Clinical skills related to pediatric pharmacy And demonstrated knowledge of best practices in clinical pediatric-related disease states.
• Current knowledge and expertise in clinical pharmacology and disease management.
• Ability to present ideas and information concisely to varied audiences.
• Knowledge of processes and systems, and ability to develop and deliver necessary training to departmental staff and internal customers.
• Ability to develops and maintain positive and effective work relationships with coworkers, members, providers, regulatory agencies and vendors.
• Proficiency in compiling data, creating reports and presenting information.
• Ability to meet established deadlines.
• Functions independently and manages multiple projects.
• Excellent verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
Preferred Qualifications
• At least 3 years of experience in a Managed Care Pharmacy, Pharmacy Benefit Manager (PBM), or related healthcare organization (ie hospital, ambulatory care, etc) experience.
• Pediatric Pharmacy Specialty Certification (BCPPS®)
• Completion of a PGY1 residency plus two (2) additional years of post-licensure practice
• Completion of a specialty (PGY2) residency in pediatric pharmacy
• Medicaid experience
• Clinical skills or pharmacotherapy expertise for clinical pediatric-related conditions and medications.
• Experience with team-based care.
#PJPharm
#LI-AC1
#HTF
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: $80,412 - $156,803.45 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
*Candidates For This Position Must Reside In/Near Queens NY*
Bilingual Highly Desired - Hindi, Bengali, Urdu and/or Arabic
Are you passionate about serving others? Do you have established relationships within the community?
Come join our growing Community Engagement team at Molina Healthcare!
Community Outreach and Engagement is more than just participating in events— at Molina, we focus on making an impact on people’s lives!
This role involves working with a wide variety of community partners to grow Molina’s membership and improve the health and well-being of the Community. Our Specialists work collaboratively with our sales team and across Molina and with each other’s regions. You will be responsible for managing events and community relationships in Brooklyn and surrounding counties. You will be in the field engaging with CBO’s (Community Based Organizations) 50% or more of the time (Molina reimburses mileage).
This position offers great flexibility and allows for you to manage your territory and schedule to meet business needs. Molina’s leadership team leads with empowering you to do what you love best by helping others.
Bilingual (Spanish) Highly Desired!
**Candidates for this position must live in or near Queens and have a reliable vehicle**
Bilingual Highly Desired - Hindi, Bengali, Urdu and/or Arabic
KNOWLEDGE/SKILLS/ABILITIES
Responsible for achieving established goals improving Molina’s enrollment growth objectives encompassing Medicaid programs. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages. Under limited supervision, responsible for carrying out enrollment events and achieving assigned membership growth targets through a combination of direct and indirect marketing activities, with the primary responsibility of improving the plan's overall “choice” rate. Works collaboratively with other key departments to increase the Medicaid assignment percentage for Molina. Works closely with other team members and management to develop/maintain/deepen relationships with key business leaders, community-based organizations (CBOs) and providers, ensuring all efforts are directed towards building membership for Medicaid and related programs. Effectively moves relationships through the “enrollment” pipeline. Responsible for achieving monthly, quarterly, and annual enrollment goals, and growth and choice targets, as established by management. Schedules, coordinates & participates in enrollment events, encourages key partners to participate, and assists where feasible. Works cohesively with Provider Services to ensure providers within assigned territory are aware of Molina products and services. Establishes simple referral processes for providers and CBOs to refer clients who may be eligible for other Molina products. Viewed as a “subject matter expert” (SME) by community and influencers on the health care delivery system and wellness topics. Delivers presentations, attends meetings and distributes educational materials to both members and potential members. Assists with all incoming calls and assist perspective members or members with health access related questions. Identify partnerships with key sponsorship opportunities and provide justification to determine Molina's participation. Identify and promote Molina's programs out in the community and creates opportunities for employees to participate. Responsible for managing their own daily schedule in alignment with department goals and initiatives as assigned by regions. Key in the development of SMART goals and provide input on department priorities.JOB QUALIFICATIONS
Required Education: Bachelor’s Degree or equivalent, job-related experience.
Preferred Education: Bachelor’s Degree in Marketing or related discipline.
Required Experience:
Min. 3 years of related experience (e.g., marketing, business development, community engagement, healthcare industry). Demonstrated exceptional networking and negotiations skills. Demonstrated strong public speaking and presentations skills. Demonstrated ability to work in a fast-paced, team-oriented environment with little supervision. Must be able to attend public events in outdoor venues in all weather conditions. Must be able to sit and stand for long periods. Must be able to drive up to 3 hours to attend events. Must be able to lift 30 pounds.Required License, Certification, Association:
Must have valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation.Preferred Experience:
Solid understanding of Health Care Markets, primarily Medicaid. Previous healthcare marketing, enrollment and/or grassroots/community outreach experience a plus. 5 years of outreach experience serving low-income populations. 3 - 5 years project management experience, preferably in a health care or outreach setting. Experience presenting to influencer and low-income audiences. Experience in sales or marketing techniques. Fluency in a second language highly desirable.Preferred License, Certification, Association:
Active Life & Health Insurance Market Place Certified#PJHPO
#LI-AC1
#HTF
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.
Key Words: health care, insurance, health insurance, Medicaid, Medicare, health coach, community health advisor, family advocate, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter and public health aide, community lead, community advocate, nonprofit, non-profit, social worker, case worker, housing counselor, human service worker, Navigator, Assistor, Connecter, Promotora, Marketing, Sales, Growth, New York, MCO, Managed Care, ACA, FQHC, Behavioral Health, CHW, Community Health Worker, Equity, DPBH, HMO, SDOH, Bilingual, South Asian, Hindi, Bengali, Urdu, Arabic
Pay Range: $18.04 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
*Candidates For This Position Must Reside In/Near Queens NY*
Bilingual Highly Desired - Hindi, Bengali, Urdu and/or Arabic
Are you passionate about serving others? Do you have established relationships within the community?
Come join our growing Community Engagement team at Molina Healthcare!
Community Outreach and Engagement is more than just participating in events— at Molina, we focus on making an impact on people’s lives!
This role involves working with a wide variety of community partners to grow Molina’s membership and improve the health and well-being of the Community. Our Specialists work collaboratively with our sales team and across Molina and with each other’s regions. You will be responsible for managing events and community relationships in Brooklyn and surrounding counties. You will be in the field engaging with CBO’s (Community Based Organizations) 50% or more of the time (Molina reimburses mileage).
This position offers great flexibility and allows for you to manage your territory and schedule to meet business needs. Molina’s leadership team leads with empowering you to do what you love best by helping others.
Bilingual (Spanish) Highly Desired!
**Candidates for this position must live in or near Queens and have a reliable vehicle**
Bilingual Highly Desired - Hindi, Bengali, Urdu and/or Arabic
KNOWLEDGE/SKILLS/ABILITIES
Responsible for achieving established goals improving Molina’s enrollment growth objectives encompassing Medicaid programs. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages. Under limited supervision, responsible for carrying out enrollment events and achieving assigned membership growth targets through a combination of direct and indirect marketing activities, with the primary responsibility of improving the plan's overall “choice” rate. Works collaboratively with other key departments to increase the Medicaid assignment percentage for Molina. Works closely with other team members and management to develop/maintain/deepen relationships with key business leaders, community-based organizations (CBOs) and providers, ensuring all efforts are directed towards building membership for Medicaid and related programs. Effectively moves relationships through the “enrollment” pipeline. Responsible for achieving monthly, quarterly, and annual enrollment goals, and growth and choice targets, as established by management. Schedules, coordinates & participates in enrollment events, encourages key partners to participate, and assists where feasible. Works cohesively with Provider Services to ensure providers within assigned territory are aware of Molina products and services. Establishes simple referral processes for providers and CBOs to refer clients who may be eligible for other Molina products. Viewed as a “subject matter expert” (SME) by community and influencers on the health care delivery system and wellness topics. Delivers presentations, attends meetings and distributes educational materials to both members and potential members. Assists with all incoming calls and assist perspective members or members with health access related questions. Identify partnerships with key sponsorship opportunities and provide justification to determine Molina's participation. Identify and promote Molina's programs out in the community and creates opportunities for employees to participate. Responsible for managing their own daily schedule in alignment with department goals and initiatives as assigned by regions. Key in the development of SMART goals and provide input on department priorities.JOB QUALIFICATIONS
Required Education: Bachelor’s Degree or equivalent, job-related experience.
Preferred Education: Bachelor’s Degree in Marketing or related discipline.
Required Experience:
Min. 3 years of related experience (e.g., marketing, business development, community engagement, healthcare industry). Demonstrated exceptional networking and negotiations skills. Demonstrated strong public speaking and presentations skills. Demonstrated ability to work in a fast-paced, team-oriented environment with little supervision. Must be able to attend public events in outdoor venues in all weather conditions. Must be able to sit and stand for long periods. Must be able to drive up to 3 hours to attend events. Must be able to lift 30 pounds.Required License, Certification, Association:
Must have valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation.Preferred Experience:
Solid understanding of Health Care Markets, primarily Medicaid. Previous healthcare marketing, enrollment and/or grassroots/community outreach experience a plus. 5 years of outreach experience serving low-income populations. 3 - 5 years project management experience, preferably in a health care or outreach setting. Experience presenting to influencer and low-income audiences. Experience in sales or marketing techniques. Fluency in a second language highly desirable.Preferred License, Certification, Association:
Active Life & Health Insurance Market Place Certified#PJHPO
#LI-AC1
#HTF
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.
Key Words: health care, insurance, health insurance, Medicaid, Medicare, health coach, community health advisor, family advocate, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter and public health aide, community lead, community advocate, nonprofit, non-profit, social worker, case worker, housing counselor, human service worker, Navigator, Assistor, Connecter, Promotora, Marketing, Sales, Growth, New York, MCO, Managed Care, ACA, FQHC, Behavioral Health, CHW, Community Health Worker, Equity, DPBH, HMO, SDOH, Bilingual, South Asian, Hindi, Bengali, Urdu, Arabic
Pay Range: $18.04 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
*Candidates For This Position Must Reside In/Near Queens NY*
Bilingual Highly Desired - Hindi, Bengali, Urdu and/or Arabic
Are you passionate about serving others? Do you have established relationships within the community?
Come join our growing Community Engagement team at Molina Healthcare!
Community Outreach and Engagement is more than just participating in events— at Molina, we focus on making an impact on people’s lives!
This role involves working with a wide variety of community partners to grow Molina’s membership and improve the health and well-being of the Community. Our Specialists work collaboratively with our sales team and across Molina and with each other’s regions. You will be responsible for managing events and community relationships in Brooklyn and surrounding counties. You will be in the field engaging with CBO’s (Community Based Organizations) 50% or more of the time (Molina reimburses mileage).
This position offers great flexibility and allows for you to manage your territory and schedule to meet business needs. Molina’s leadership team leads with empowering you to do what you love best by helping others.
Bilingual (Spanish) Highly Desired!
**Candidates for this position must live in or near Queens and have a reliable vehicle**
Bilingual Highly Desired - Hindi, Bengali, Urdu and/or Arabic
KNOWLEDGE/SKILLS/ABILITIES
Responsible for achieving established goals improving Molina’s enrollment growth objectives encompassing Medicaid programs. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages. Under limited supervision, responsible for carrying out enrollment events and achieving assigned membership growth targets through a combination of direct and indirect marketing activities, with the primary responsibility of improving the plan's overall “choice” rate. Works collaboratively with other key departments to increase the Medicaid assignment percentage for Molina. Works closely with other team members and management to develop/maintain/deepen relationships with key business leaders, community-based organizations (CBOs) and providers, ensuring all efforts are directed towards building membership for Medicaid and related programs. Effectively moves relationships through the “enrollment” pipeline. Responsible for achieving monthly, quarterly, and annual enrollment goals, and growth and choice targets, as established by management. Schedules, coordinates & participates in enrollment events, encourages key partners to participate, and assists where feasible. Works cohesively with Provider Services to ensure providers within assigned territory are aware of Molina products and services. Establishes simple referral processes for providers and CBOs to refer clients who may be eligible for other Molina products. Viewed as a “subject matter expert” (SME) by community and influencers on the health care delivery system and wellness topics. Delivers presentations, attends meetings and distributes educational materials to both members and potential members. Assists with all incoming calls and assist perspective members or members with health access related questions. Identify partnerships with key sponsorship opportunities and provide justification to determine Molina's participation. Identify and promote Molina's programs out in the community and creates opportunities for employees to participate. Responsible for managing their own daily schedule in alignment with department goals and initiatives as assigned by regions. Key in the development of SMART goals and provide input on department priorities.JOB QUALIFICATIONS
Required Education: Bachelor’s Degree or equivalent, job-related experience.
Preferred Education: Bachelor’s Degree in Marketing or related discipline.
Required Experience:
Min. 3 years of related experience (e.g., marketing, business development, community engagement, healthcare industry). Demonstrated exceptional networking and negotiations skills. Demonstrated strong public speaking and presentations skills. Demonstrated ability to work in a fast-paced, team-oriented environment with little supervision. Must be able to attend public events in outdoor venues in all weather conditions. Must be able to sit and stand for long periods. Must be able to drive up to 3 hours to attend events. Must be able to lift 30 pounds.Required License, Certification, Association:
Must have valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation.Preferred Experience:
Solid understanding of Health Care Markets, primarily Medicaid. Previous healthcare marketing, enrollment and/or grassroots/community outreach experience a plus. 5 years of outreach experience serving low-income populations. 3 - 5 years project management experience, preferably in a health care or outreach setting. Experience presenting to influencer and low-income audiences. Experience in sales or marketing techniques. Fluency in a second language highly desirable.Preferred License, Certification, Association:
Active Life & Health Insurance Market Place Certified#PJHPO
#LI-AC1
#HTF
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.
Key Words: health care, insurance, health insurance, Medicaid, Medicare, health coach, community health advisor, family advocate, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter and public health aide, community lead, community advocate, nonprofit, non-profit, social worker, case worker, housing counselor, human service worker, Navigator, Assistor, Connecter, Promotora, Marketing, Sales, Growth, New York, MCO, Managed Care, ACA, FQHC, Behavioral Health, CHW, Community Health Worker, Equity, DPBH, HMO, SDOH, Bilingual, South Asian, Hindi, Bengali, Urdu, Arabic
Pay Range: $18.04 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
