Remote Jobs at Molina Healthcare

Job Description Job Summary... Manage new broker applications, enrollment forms, educating on plan benefits in all markets and making sure CMS requirements are being met in these processes. Knowledge/Skills/Abilities • Handles new broker applications, enrollment forms. • Educates Brokers on plan benefits in all markets. • Makes sure CMS requirements are being met in the aforementioned processes. • Answers In-bound phone calls – Develop and maintain single point of contact by answering inquiries from National Brokers regarding application submittals, Medicare Advantage products, and supply requests and fulfillment.. • Medicare Experience Job Qualifications Required Education High school diploma or GED Required Experience 1-3 Years 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 O ...

JOB DESCRIPTION Job Summary... 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. KNOWLEDGE/SKILLS/ABILITIES • 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 relationshi ...

JOB DESCRIPTIONThis is a remote job position with 15% travel in the state of Iowa. Employee must reside in Iowa*Job SummaryThe Employment Specialist assists members with connections to new employment opportunities or workforce development programs to secure stable employments. Collaborates with community rehabilitation providers and establishes relationships with provider agencies to identify... temporary work options.KNOWLEDGE/SKILLS/ABILITIESEstablishes connections with businesses for program development to create job opportunitiesEngages directly with enrolled members to assist with connection to new employment opportunities or workforce development programs to help them secure stable employmentEstablishes connections with workforce development programs promoting collaboration and support to providers and agencies, increasing job placements of enrolled membersEstablishes relationships with provider agencies to identify types of temporary work options and assists teams in referring j ...

JOB DESCRIPTION Job Summary... The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health plan performance and identify the root causes of medical cost trends. With those root causes identified, drives innovation by creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex analyses of insured medical populations with the goal of identifying opportunities to improve financial performance. Extracts, analyzes, and synthesizes data from various sources to identify risks and opportunities. Job Duties • Extract and compile information from various systems to support executive decision-making • Mine and manage information from large data sources. • Analyze claims and other dat ...

JOB DESCRIPTION Job Summary... The role is responsible for establishing premium rates and conducting financial analysis and reporting. A key responsibility of this role is supporting the Molina Marketplace ACA individual pricing process by developing rates, creating regulatory filing documents, and addressing regulatory objections. The candidate may lead multiple projects of varying scale and complexity with limited direct supervision. KNOWLEDGE/SKILLS/ABILITIES • Analyzes data, assists in designing studies, authors effective communication, and generates recommendations with supporting documentation. • Analyzes emerging experience to monitor medical cost trends and identify early signs of potential issues. • Implements high level tactics and strategies with limited guidance. • Possesses subject matter expertise in at least one actuarial function (pricing, reserving, risk adjustment, analytics, modeling, etc.) • Leads an analytical project from beginning to end with limited ...

Job Description Job Summary... We are seeking a highly skilled and adaptable actuary responsible for pricing Molina Marketplace ACA Individual Products. The ideal candidate will thrive in a space characterized by dynamic rules and competitive shifts. You will play a critical role in analyzing market trends, developing models and providing data-driven insights to guide strategic decisions in a high-stakes environment. KNOWLEDGE/SKILLS/ABILITIES • Develop Individual ACA rates, prepare and sign rate filings, and respond to regulator objections • Demonstrate a strong understanding of ACA risk adjustment concepts • Design and evaluate plan offerings • Monitor financial projections and adapt models to reflect emerging trends and market changes • Conduct scenario analysis and stress tests to evaluate the potential impact of market shifts • Evaluate competitors and market conditions • Exhibit curiosity and the ability to adapt and understand market trends and changes • Commu ...

Job Description Job Summary... The Vice President, Enterprise Integration, will provide critical operational analysis, analytics and actionable intelligence and information to Molina's senior leadership team to facilitate prudent, timely decision making. Makes actionable recommendations on both strategy and operations at the business unit and corporate level related to the integration of acquisitions, the implementation of new markets and/or products and business process improvement initiatives. Works collaboratively with executive leadership, the senior management team and business unit leaders to lead the integration of mergers and acquisitions, implementations, and execution of short and long-term process improvement and business strategies to further Molina's growth, business success, and fiscal performance in the ever-changing healthcare environment. Knowledge/Skills/Abilities • Prioritize and execute on enterprise initiatives that drive growth and optimization through M&amp ...

Molina Healthcare is Hiring For Medicare Pharmacy, Customer Service Reps! These roles are remote within the US, however you will be working MST (Mountain Standard Time) business hours... Preferred Availability is between the hours of 1230pm to 9pm -or- 1030am-7p, -or- 10-630 MST (All Monday through Friday) As a CSR in our Medicare Pharmacy Department, you will service Medicare members that have questions or experiencing issues related to pharmacy benefits. You will assist with inbound calls from members and providers regarding pharmacy benefit explanations such as copays and coverage phases, assisting with prior authorizations for non-covered medications, overrides, aiding pharmacy with billing information. You will also be making outbound calls to providers offices or pharmacy’s depending on the issue but majority of the time you are taking inbound calls. Highly Qualified Candidates Will Have The Following: • Experience working in healthcare some capacity - Pharmacy or Health ...

Job Description Job Summary... Analyzes and determines training needs and problems. Develops, administers and implements all training programs in accordance with the Business' initiatives and strategies. Conducts special courses designed for training selected groups of employees. Operates independently to effectively lead and manage classes, adapting to changing priorities and operating environments as needed. Knowledge/Skills/Abilities • Consults with plan/Corporate leadership in assessing and meeting specific training needs. • Develops/Conducts training including both group facilitation as well as individual coaching to mitigate skill gaps. • Conducts needs analyses for beginning to intermediate complexity training projects. • Evaluates data and organizational needs to identify learning and development issues. Works with the department management to design and implement improvements. • Designs curriculum for beginning to intermediate complexity including Level 3 eval ...