- Molina Healthcare (Dayton, OH)
- …payment integrity and other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management ... + 3-5 years in Managed Care with emphasis on Managed Care Operations **Preferred License, Certification, Association** + PMP, CAPM, PMI-ACP, PMI-PBA… more
- Molina Healthcare (Dayton, OH)
- …+ 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare ... DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and… more
- Molina Healthcare (Dayton, OH)
- …or equivalent combination of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or ... level (or higher) **Preferred Education** Bachelor's Degree **Preferred Experience** + 5+ years managed care experience + QNXT; SQL experience + Crystal Reports… more
- Molina Healthcare (Dayton, OH)
- …**Required Experience** + 5-7 years of business analysis experience, + 6+ years managed care experience. + Demonstrates proficiency in a variety of concepts, ... with multiple types of business data. May be internal operations -focused or external client-focused. **KNOWLEDGE/SKILLS/ABILITIES** + Elicit requirements using… more
- Molina Healthcare (Dayton, OH)
- …in billing, claims, encounters, and data analysis + 5 years or more of managed care experience + Knowledge of advanced data analysis techniques + Skilled ... with preparing portions of materials and information for Monthly Governance and Operations Reviews + Performs root cause analysis of claims and encounter data… more
- Molina Healthcare (Dayton, OH)
- …SKILLS & ABILITIES** : * 7+ years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including 2+ years ... activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider… more
- Molina Healthcare (Dayton, OH)
- …**Required Experience** + 10+ years progressive experience in Healthcare Administration, Managed Care and/or Provider Services. + Experience managing employees. ... activities of the State Plan's Provider Network Management and Operations Department. Works with staff and senior ...related field. **Preferred Experience** Experience with Medicaid and Medicare managed care plans. \#PJHPO \#LI-AC1 To all… more
- Molina Healthcare (Dayton, OH)
- …years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care environment, or ... care management, long-term services and supports (LTSS), clinical operations and business processes. Considers business problems "end-to-end": including people,… more
- Molina Healthcare (Dayton, OH)
- …Qualifications** **REQUIRED QUALIFICATIONS:** + At least 10 years' experience in Managed Care , specifically government programs and/or Medicare/Duals Health Plan ... and market leadership on mutual growth opportunities. + Works with senior management to mitigate risk and develop/implement improvements for all operational… more