- Molina Healthcare (Kearney, NE)
- …design solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience, Enrollment, and Claims ... **Job Description** **Job Summary** The Network Solutions Director is responsible for leading a team designing...combination of education and experience **Required Experience** 7-9 years Provider Data **Preferred Education** Graduate Degree or… more
- Molina Healthcare (Kearney, NE)
- … Information process functions. * Directs the development, implementation and maintenance of provider data in the claims payment system. * Supports critical ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Molina Healthcare (Kearney, NE)
- …optimization, and service delivery + Overseeing implementation of scalable solutions for provider onboarding, data management , and credentialing operations + ... **JOB DESCRIPTION** **Job Summary** Lead operational readiness initiatives across provider data and credentialing functions, supporting both new implementations… more
- Molina Healthcare (Kearney, NE)
- **Job Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment, is responsible for the implementation, monitoring, and oversight ... and data completeness training, onboarding for CDA team members, vendor management for chart collection vendors, Supplemental data , and chart collection… more
- Molina Healthcare (Kearney, NE)
- …regarding utilization practices, guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization Management ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Kearney, NE)
- …of value-based care models, provider enablement strategies, and population health management . + Strong knowledge of data integration, EMR systems, and ... programs focused on provider enablement, ensuring access to tools, training, and data for success in VBC models. + Design and implement VBC training programs,… more
- Molina Healthcare (Kearney, NE)
- **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial and ... of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment… more
- Molina Healthcare (Kearney, NE)
- …Compliance. + Implements key quality strategies, which may include initiation and management of provider , member and/or community interventions (eg, removing ... programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities;… more
- Molina Healthcare (Kearney, NE)
- …member of Molina Healthcare's Protection Services Operations Center, reporting to the Director . This role is crisis and threat intelligence focused and includes ... the physical security controls, threat/risk analytics, and incident intake and crisis management support for the enterprise. This role drives and manages physical… more