Molina Healthcare Jobs in Phenix City, AL

JOB DESCRIPTION Job Summary Analyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality care with improved outcomes through better coordination and preventive care and develop payment strategies that give incentives to providers and healthcare systems that deliver better health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy...

JOB DESCRIPTION Job Summary Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to other end users for operational and strategic analysis. KNOWLEDGE/SKILLS/ABILITIES Manages and provides direct oversight of Medical Economics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the...

JOB DESCRIPTION Job Summary Responsible for analysis of financial reports, budgeting and forecasting for Health Plan G&A. Duties include focus on labor cost management, business partner alignment, gathering, interpreting, and evaluating financial information; generating forecasts and analyzes trends in headcount, hiring trends, and other non-labor expenses. KNOWLEDGE/SKILLS/ABILITIES Forecasts and monitors G&A expense across several health plans in a Managed Care environment economic benefits of Molina investments in infrastructure and operations (enhancements in operating efficiency and...

Job Description Job Summary Develops and implements staffing strategies including development of sourcing approaches, interview and selection processes, university recruitment programs and company branding.   Knowledge/Skills/Abilities • Writes complete and detailed search assignments, ensuring an understanding of the job duties, responsibilities, and business requirements. • Develops and maintains strong working relationships with leaders, hiring managers and other team members to create a partnership that yields success, predictable results and credibility. • Leverages online recruiting...

JOB DESCRIPTION Molina Healthcare, is Supervisor, Member Services who lives in the State of Nevada. Job Summary Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information and identifies opportunities to improve our member and provider experiences. KNOWLEDGE/SKILLS/ABILITIES Supervises a team of employees. Trains, coaches, monitors, and manages the team’s performance to meet or exceed company and...

JOB DESCRIPTION Job Summary Responsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial projects or programs. Duties include gathering, interpreting, and evaluating financial information; generating forecasts and analyzes trends in sales, finance and other areas of business; Creating financial models for future business planning decisions in areas such as new product development, new marketing strategies, etc. KNOWLEDGE/SKILLS/ABILITIES...

JOB DESCRIPTION Job Summary Responsible for developing the organization's short- and long-term financial plans and identifying financial opportunities to improve the organization's profitability. Ideal candidates would have prior experience with balance sheet reconciliation and cash flow forecasting. Qualified candidates selected to move forward in the process for this role will be given an Excel prompt to present cash flow model skills. KNOWLEDGE/SKILLS/ABILITIES Manages timely submission of analytics and reports required for the FP&A function Responsible for ensuring the integrity and...

JOB DESCRIPTION Job Summary Performs 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. KNOWLEDGE/SKILLS/ABILITIES Develops, implements, and uses software and systems to support the department's goals. Develops and generates ad-hoc and standard reports using SQL programming, SQL Server Reporting Services (SSRS), Medinsight, RxNavigator, Crystal Reports,...

JOB DESCRIPTION Job Summary Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment questions or concerns received via call tracking, claims, or e-mail. Maintain records in the enrollment database. KNOWLEDGE/SKILLS/ABILITIES Performs processes to resolve the following eligibility exceptions...

JOB DESCRIPTION Job Summary Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment questions or concerns received via call tracking, claims, or e-mail. Maintain records in the enrollment database. KNOWLEDGE/SKILLS/ABILITIES Performs processes to resolve the following eligibility exceptions...

JOB DESCRIPTION Job Summary Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards. KNOWLEDGE/SKILLS/ABILITIES Process outpatient, inpatient, and professional claims. Assists with claims adjudication Inventory management. Perform daily troubleshooting procedures to support enrollment, disenrollment, claims, and claims support functions...

JOB DESCRIPTION Job Summary Performs 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. KNOWLEDGE/SKILLS/ABILITIES Develops, implements, and uses software and systems to support the department's goals. Develops and generates ad-hoc and standard reports using SQL programming, SQL Server Reporting Services (SSRS), Medinsight, RxNavigator, Crystal Reports,...

JOB DESCRIPTION Job Summary Analyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality care with improved outcomes through better coordination and preventive care and develop payment strategies that give incentives to providers and healthcare systems that deliver better health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy...

JOB DESCRIPTION Job Summary Develops and implements staffing strategies including development of sourcing approaches, interview and selection processes, university recruitment programs and company branding. KNOWLEDGE/SKILLS/ABILITIES Confers with hiring managers to identify personnel needs, search assignments. Visits hiring managers to understand job duties, responsibilities, and business requirements. Develops and maintains strong working relationships with hiring managers; develops and maintains a network of contacts to help identify and source qualified professionals. Reviews resumes and...

JOB DESCRIPTION Job Summary Responsible for analysis of financial reports, budgeting and forecasting for Health Plan G&A. Duties include focus on labor cost management, business partner alignment, gathering, interpreting, and evaluating financial information; generating forecasts and analyzes trends in headcount, hiring trends, and other non-labor expenses. KNOWLEDGE/SKILLS/ABILITIES Forecasts and monitors G&A expense across several health plans in a Managed Care environment economic benefits of Molina investments in infrastructure and operations (enhancements in operating efficiency and...

JOB DESCRIPTION Job Summary Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements. KNOWLEDGE/SKILLS/ABILITIES Trains staff on configuration...

JOB DESCRIPTION Job Summary Develops and implements staffing strategies including development of sourcing approaches, interview and selection processes, university recruitment programs and company branding. KNOWLEDGE/SKILLS/ABILITIES Confers with hiring managers to identify personnel needs, search assignments. Visits hiring managers to understand job duties, responsibilities, and business requirements. Develops and maintains strong working relationships with hiring managers; develops and maintains a network of contacts to help identify and source qualified professionals. Reviews resumes and...

JOB DESCRIPTION Job Summary Responsible for analysis of financial reports, budgeting and forecasting for Health Plan G&A. Duties include focus on labor cost management, business partner alignment, gathering, interpreting, and evaluating financial information; generating forecasts and analyzes trends in headcount, hiring trends, and other non-labor expenses. KNOWLEDGE/SKILLS/ABILITIES Forecasts and monitors G&A expense across several health plans in a Managed Care environment economic benefits of Molina investments in infrastructure and operations (enhancements in operating efficiency and...

JOB DESCRIPTION Job Summary Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to other end users for operational and strategic analysis. KNOWLEDGE/SKILLS/ABILITIES Manages and provides direct oversight of Medical Economics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the...

JOB DESCRIPTION Job Summary This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing risk score models with SQL, organizing and managing large and varied data sets, analyzing healthcare data for decision support, and communicating findings. Qualified candidates are the diligent problem solvers who have Risk Adjustment experience with advanced skills in SQL. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data. Collaborates...

JOB DESCRIPTION Job Summary Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements. KNOWLEDGE/SKILLS/ABILITIES Trains staff on configuration...

JOB DESCRIPTION Job Summary Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements. KNOWLEDGE/SKILLS/ABILITIES Trains staff on configuration...

JOB DESCRIPTION Job Summary Responsible for developing the organization's short- and long-term financial plans and identifying financial opportunities to improve the organization's profitability. Ideal candidates would have prior experience with balance sheet reconciliation and cash flow forecasting. Qualified candidates selected to move forward in the process for this role will be given an Excel prompt to present cash flow model skills. KNOWLEDGE/SKILLS/ABILITIES Manages timely submission of analytics and reports required for the FP&A function Responsible for ensuring the integrity and...

JOB DESCRIPTION Molina Healthcare, is Supervisor, Member Services who lives in the State of Nevada. Job Summary Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information and identifies opportunities to improve our member and provider experiences. KNOWLEDGE/SKILLS/ABILITIES Supervises a team of employees. Trains, coaches, monitors, and manages the team’s performance to meet or exceed company and...

JOB DESCRIPTION Job Summary Responsible for analysis of financial reports, budgeting and forecasting for Health Plan G&A. Duties include focus on labor cost management, business partner alignment, gathering, interpreting, and evaluating financial information; generating forecasts and analyzes trends in headcount, hiring trends, and other non-labor expenses. KNOWLEDGE/SKILLS/ABILITIES Forecasts and monitors G&A expense across several health plans in a Managed Care environment economic benefits of Molina investments in infrastructure and operations (enhancements in operating efficiency and...

JOB DESCRIPTION Job Summary Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements. KNOWLEDGE/SKILLS/ABILITIES Trains staff on configuration...

JOB DESCRIPTION Job Summary Responsible for analysis of financial reports, budgeting and forecasting for Health Plan G&A. Duties include focus on labor cost management, business partner alignment, gathering, interpreting, and evaluating financial information; generating forecasts and analyzes trends in headcount, hiring trends, and other non-labor expenses. KNOWLEDGE/SKILLS/ABILITIES Forecasts and monitors G&A expense across several health plans in a Managed Care environment economic benefits of Molina investments in infrastructure and operations (enhancements in operating efficiency and...

JOB DESCRIPTION Job Summary Responsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial projects or programs. Duties include gathering, interpreting, and evaluating financial information; generating forecasts and analyzes trends in sales, finance and other areas of business; Creating financial models for future business planning decisions in areas such as new product development, new marketing strategies, etc. KNOWLEDGE/SKILLS/ABILITIES...

JOB DESCRIPTION Job Summary Performs 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. KNOWLEDGE/SKILLS/ABILITIES Develops, implements, and uses software and systems to support the department's goals. Develops and generates ad-hoc and standard reports using SQL programming, SQL Server Reporting Services (SSRS), Medinsight, RxNavigator, Crystal Reports,...