Molina
Open positions
Clinical Validation Reviewer, RN - Inpatient Coding & Reimbursement
Seeking an RN with inpatient coding, clinical validation, reimbursement, DRG review, and/or payment integrity experience. This is not a traditional bedside nursing role. Candidates should have experience interpreting…
Project Manager / Process Improvement Lead (Appeals & Grievances)
JOB DESCRIPTION Job Summary Provides support for internal business projects from inception through delivery. Plans and managed project schedules, milestones, budgets, stakeholder involvement, and quality/delivery.…
Director, National Quality Interventions (Member Programs) - REMOTE
Job Summary Leads and directs team responsible for quality interventions activities. Responsible for planning, implementing, and overseeing new and existing health care quality improvement (QI) initiatives and…
Program Manager, Healthcare Services - Clinical Analytics/Pega/CCA - Remote
***Remote and must live in the United States*** JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership to support the alignment and implementation of enterprise healthcare services strategies…
Program Manager (Clinical COE)
JOB DESCRIPTION Job Summary Become a member of the Clinical Operations Enablement team as we guide the implementation of the Clinical COE vision throughout the Molina enterprise. This position offers the opportunity to…
Clinical Validation Reviewer (DRG-RN)
Job Summary Provides support for inpatient and outpatient clinical claim review activities. Verifies that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies accurately reflect the…
Program Manager, Medicare Stars & Quality Improvement (Remote in Idaho)
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…
Program Manager (MMISR - MST hours)
JOB DESCRIPTION Job Summary Provides support to Molina MMISR IT areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets,…