- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and ... predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs ... are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare/MMP product in support of ... strategic and corporate business objectives. Support for all Medicare lines of business the annual Medicare and Medicare-Medicaid Plan Applications and Plan Benefit Package design. Provides centralized year-round support in Medicare for the development and… more
- Molina Healthcare (Caldwell, ID)
- …**Required Education** Completion of an accredited Registered Nurse (RN) Program and Associate's or bachelor's degree in Nursing OR Bachelor's or master's degree in ... **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM). + Monitors… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Responsible for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized ... representatives) in accordance with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution of the appeals, dispute, grievances, and/or… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** The AVP Proposal Strategy is dedicated to maximizing Molina's likelihood of winning Medicaid RFPs. The AVP must have the executive presence and ... communication skills required to build trust across stakeholders to package Molina's winning Proposal for state partners, synthesize business development and capture activities, and map key solutions and strategies which align with anticipated RFPs. Reporting… more
- Johnson Thermal Systems (Caldwell, ID)
- …are seeking a highly organized and detail-orientedProduction Coordinatorto support the planning, scheduling, and execution of production activities. This role serves ... as a vital link between departments, ensuring efficient communication, resource allocation, and workflow to meet project deadlines and quality standards. Who You Are: Detail Oriented: You must pay close attention to the specifics and fine details of each task… more
- Walmart (Caldwell, ID)
- …Additional compensation includes annual or quarterly performance incentives. Additional compensation in the form of premiums may be paid in amounts ranging from $0.35 ... per hour to $3.00 per hour in specific circumstances. Premiums may be based on schedule, facility, season, or specific work performed. Multiple premiums may apply if applicable criteria are met. Employment Type: **Full-Time** Available shifts: **Mid-Shift,… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** The role, reporting directly to the Head of Strategy, is a critical member of the Strategy team, which supports senior executives in creating ... corporate, business unit, and local strategies as well as driving key strategic initiatives to transform the Company. **Job Duties** + Develops enterprise and domain-specific strategies to drive growth, compliance, and performance improvement within current… more
- Johnson Thermal Systems (Caldwell, ID)
- …The Tank Tester is responsible for conducting pressure and leak tests on industrial fuel storage tanks used for backup power diesel Caterpillar engines. This role ... ensures that all tanks meet industry standards, safety regulations, and company quality requirements before delivery or installation. The ideal candidate has experience in industrial testing procedures, understands welding integrity, and follows strict safety… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider ... information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Responsible for the development and maintenance of an effective and efficient broker channel for assigned geographical region. Work in collaboration ... with other Broker Channel Managers, Field Sales Managers, Directors, and AVPs as needed in assigned states. Develop a high functioning, high performing broker network which is strategically aligned with Molina's mission and values. Utilize a combination of… more
- Molina Healthcare (Caldwell, ID)
- …For this position we are seeking a supervisor to manage an operations call center The supervisor of HCS Operations will manage a team of remote Member Navigators who ... are working in an inbound/outbound call center environment supporting our members and Nurse Practitioner Staff. We are looking for a candidate with operations experience, leading/managing a team, and experience working and supporting associates in a remote… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are appropriately applied. ... Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints, legal requests, or identified internally by Molina. Identifies the root cause of processing errors through research… more
- HCA Healthcare (Caldwell, ID)
- …Hourly Wage Estimate: $23.62 - $35.44 / hour Learn more about the benefits offered ( https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards ) for this ... job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Focuses on process improvement, organizational change management, project management and other processes relative to the business. Project management ... includes estimating, scheduling, costing, planning, and issue/risk management. **KNOWLEDGE/SKILLS/ABILITIES** + Proven depth of understanding and demonstrable results for effective management of intermediate to large-scale projects, using prescribed… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Provides leadership and direction to their Sales channels in all approved Molina markets. Serve as the primary contact for their channel's ... distribution of assigned Molina products, and resolution of operational issues, by either directly handling or escalating to the attention of the AVP so appropriate action can be taken. Works directly with their channel management staff and other department… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance standards. This position ... will support our Claims business. The candidate must have an unrestricted RN license. This position will performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which an appeal has been… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Provides leadership and direction to their Sales channels in all approved Molina markets. Serve as the primary contact for their channel's sales and ... distribution of assigned Molina products and work cross-functionally across the organization with State leadership and MHI Enterprise for strategy development and execution resolution of operational issues. Work with data management and business analysts to… more
- Molina Healthcare (Caldwell, ID)
- …**Job Summary** Telesales role. Responsible for taking and making telephone calls with prospective members with the intent to educate them on benefits of Molina ... products and then conducts enrollment into product of choice over the phone or other sales enrollment channel desired. **Knowledge/Skills/Abilities** * Strong working knowledge of Medicare and Medicaid and other government health programs/ income assistance… more