Molina Healthcare jobs in Buffalo, NY - 95 jobs

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. * Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. * Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. * Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. * Assists in reviews of state and federal complaints related to claims. * Collaborates with other internal departments to determine appropriate resolution of claims issues. * Researches claims tracers, adjustments, and resubmissions of claims. * Adjudicates or readjudicates high volumes of claims in a timely manner. * Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. * Meets claims department quality and production standards. * Supports claims department initiatives to improve overall claims function efficiency. * Completes basic claims projects as assigned. Required Qualifications * At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. * Research and data analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Customer service experience. * Effective verbal and written communication skills. * Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Highlights: * This a full time role - Overtime eligible * This job is Monday - Friday 7/8 - 3:30/4;30 - NO WEEKENDS * Fulltime Benefits * 5% yearly Bonus * Two step interview process Job Requirements/Responsibilities: * Perform inventory management functions when necessary, such as order filling, receiving, cutting cases, product put-away, process store credit returns, expired/damaged product returns, reconciliation processing, cycle count process, processing shipping and returns to the Distribution Center, product additions and subtractions. * Process inventory workflow of facility in accordance with daily goals and functions * Adherence and compliance to policies, Standard Operating Procedures (SOP's) and Safety guidelines of facility * Communicate with peers and supervisors about operational concerns, assist in resolving these concerns and issues as they arise. Execute planned work assignments as assigned and needed * Comfortable using a computer. Knowledge of Microsoft Office suite preferred. * Adhere to and promote the company's I2CARE/ILEAD Principles * Ability to work independently and in small teams * Any other assigned tasks Minimum Qualifications: * High School Diploma or equivalent * Self-starter * Ability to execute physical tasks, lifting up to 30lb cases of product during the first 2-3 hours of the shift * Central Fill production and/or previous receiving or inventory warehouse experience preferred * Must be computer proficient * Knowledge/familiarity with production and inventory functions and/or background preferred * Must meet company established attendance requirements and guidelines. Physical Requirements (Lifting, standing, etc.) * Standing and walking frequently throughout shift * Ability to perform lifting (weights based on product)-Pallet jacks, bending, reaching * Must be able to work mandatory overtime (This description is general in nature and is not intended to be an exhaustive list of all responsibilities. Other duties may be assigned as needed to meet company goals. Hours and responsibilities are subject to change based on the business need) We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here. Our Base Pay Range for this position $16.59 - $27.65 McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind: McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application. McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates. McKesson job postings are posted on our career site: careers.mckesson.com. McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Work Schedule: * Part time, 25 to 28 hours a week * Fridays and Sundays are mandatory * Sundays 2pm to 10:30pm * Fridays 2pm to 10:30pm * Then either a 2pm to 10:30pm or 6pm to 10:30pm shift a few more nights throughout the week Pay: $18.00/hour plus $1.00/hour shift differential Key Responsibilities: * Pick, pack and ship prescriptions directly to retail pharmacies and end-customer in a fast-paced semi-automated production environment. * Ability to fill, pack and ship prescriptions with 100% accuracy and efficiency using Standard Operating Procedures (SOP) and McKesson supported hardware and software. * Able to read computer generated screens, find indicated merchandise on labeled shelves, and verify quantity and dosage of the product before selecting for order. * Examines stock and distributes materials in inventory. * Also responsible for maintenance and housekeeping, proper storage of goods, ensuring correct reliable shelf labels for merchandise locations, and other duties as assigned. * May require mandatory overtime based on business need. Minimum Requirements: * Typically requires 1+ years of related experience Critical Skills: * 0-1 years of proven experience with excellent attention to detail * 0-1 years' experience in a quality focused role Additional Qualifications/Job Information: * Excellent attention to detail * Quality focused Physical Requirements: * Able to select and lift objects from shelves and carry to order filling line. Able to consistently carry 20-30 lbs. of merchandise short distances and 15 lbs. of merchandise on an extended basis from order filling station to conveyor. * Must be able to walk and stand throughout the entire shift. Internal Applicants: * Must meet established attendance requirements. * Must not currently be on progressive discipline - written or final written warning. * Must currently maintain acceptable standards and quality in present position. * Current McKesson employee who has completed 90 day probationary period. Please note if you are still on your probationary period and are interested in this position please see your supervisor, if no internal candidates whom have completed their probation apply then you may put in a internal application for consideration. We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here. McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!

Provides support for coordination of benefits review activities that directly impact medical expenses and premium reimbursement. Responsible for primarily coordinating benefits with other carriers responsible for payment. Facilitates administrative support, data entry, and accurate maintenance of other insurance records. Job Duties * Provides telephone, administrative and data entry support for the coordination of benefits (COB) team. * Phones or utilizes other insurance company portals to validate state, vendor, and internal COB leads. * Updates the other insurance table on the claims transactional system and COB tracking database. * Review of claims identified for overpayment recovery. Job Qualifications REQUIRED QUALIFICATIONS: * At least 1 year of administrative support experience, or equivalent combination of relevant education and experience. * Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines. * Strong verbal and written communication skills. * Ability to work cross-collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders. * Microsoft Office suite proficiency. PREFERRED QUALIFICATIONS: * Health care experience To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.65 - $31.71 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). Essential Job Duties * Enters denials and requests for appeals into information system and prepares documentation for further review. * Researches claims issues utilizing systems and other available resources. * Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines. * Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research. * Determines appropriate language for letters and prepares responses to member appeals and grievances. * Elevates appropriate appeals to the next level for review. * Generates and mails denial letters. * Provides support for interdepartmental issues to help coordinate problem-solving in an efficient and timely manner. * Creates and/or maintains appeals and grievances related statistics and reporting. * Collaborates with provider and member services to resolve balance bill issues and other member/provider complaints. Required Qualifications * At least 1 year of experience in claims, and/or 1 year of customer/provider service experience in a health care setting, or equivalent combination of relevant education and experience. * Customer service experience. * Organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines. * Effective verbal and written communication skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Customer/provider experience in a managed care organization (Medicaid, Medicare, Marketplace and/or other government-sponsored program), or medical office/hospital setting experience. * Completion of a health care related vocational program (i.e., certified coder, billing, or medical assistant). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.65 - $34.88 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

**JOB DESCRIPTION** **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 and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers. + Sets up process for monitoring, tracking, and trending department data. + Prepares any state mandated reports and analysis. + Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes. + Implements and uses the analytics software and systems to support the departments goals. **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent combination of education and experience **Required Experience** 1-3 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 3-5 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 Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides support for pharmacy technician activities. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: (11 AM-7:30 PM MST or 12:30-9 PM MST)** Essential Job Duties - Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests. - Accurately enters approvals or denials of requests. - Facilitates prior authorization requests within established pharmacy policies and procedures. - Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices. - Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership. - Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues. - Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed. Required Qualifications - At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience. - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Ability to abide by Molina policies. - Ability to maintain attendance to support required quality and quantity of work. - Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA). - Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers. - Excellent verbal and written communication skills. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $31.71 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the Vice President, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development. This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position. Job Duties * Strategy Development & Innovation * Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements * Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD * Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition * Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning * Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care * Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively * Market Development and Strategy Execution * Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders * Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery * Stakeholder Engagement & Thought Leadership * Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes * Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions * Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations * Proposal Support & Competitive Differentiation * Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content * Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape * Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements * Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies * Operational Excellence & Cross-Functional Coordination * Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning * Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements * Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams * Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently * Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership * Mentorship & Team Development * Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning * Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership * 50% or more Travel required Job Qualifications REQUIRED QUALIFICATIONS: * Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience * 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field * Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations * Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions * Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data * Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations * Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation PREFERRED QUALIFICATIONS: * Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration * 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members) * Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data * Conference management experience and participation in industry forums 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 Opportunity Employer (EOE) M/F/D/V Pay Range: $107,028 - $208,705 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Leads and supervises a team of pharmacy call center representatives and operations staff responsible to ensure that members have access to medically necessary prescription drugs. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties * Hires, trains, develops, and supervises a team of pharmacy service representatives supporting processes involved with Medicare Stars and Pharmacy quality operations. * Ensures that average phone call handle time, average speed to answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. * Ensures that adequate staffing coverage is present at all times of operation. * Assists pharmacy leadership with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager (PBM) for pharmacy contractually delegated functions. * Responsible for key performance indicators (KPI) reporting to department leadership on a monthly basis. * Participates, researches, and validates materials for both internal and external program audits. * Acts as liaison to internal and external customers to ensure prompt resolution of identified issues. * Assists pharmacy leadership in the collection and tabulation of data for reporting purposes and maintains files of confidential information submitted for review. * Assures that activities and processes are compliant with CMS, National Committee of Quality Assurance (NCQA) guidelines, and Molina policies and procedures. * Participates in the daily workload of the department, performing Representative duties as needed. * Facilitates interviews with pharmacy service representative job applicants, and provides hiring recommendations to leadership. * Provides coaching for pharmacy representatives, and helps identify and provide for training needs in collaboration with pharmacy leadership. * Communicates effectively with practitioners and pharmacists. * Collaborates with and keeps pharmacy leadership apprised of operational issues, including staffing resources, program and system needs. * Assists with development of and maintenance of pharmacy policies and procedures * Participates in the development of programs designed to enhance preferential or required targeted drugs or supplies. Required Qualifications * At least 5 years of experience in health care, preferably within a health-related call center environment, or equivalent combination of relevant education and experience. * Knowledge of prescription drug products, dosage forms and usage. * Experience designing, implementing, monitoring, and evaluating metrics that measure call center agent productivity. * Working knowledge of medical/pharmacy terminology * Excellent verbal and written communication skills. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Supervisory/leadership experience. * Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. * Call center experience. * Managed care experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $55,706.51 - $80,464.96 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

The Marketplace Facilitated Enroller (MFE) is responsible for identifying prospective members that do not have health insurance and assisting with the enrollment process ultimately making it easier for them to connect to the care they need. The MFE conducts interviews and screens potentially eligible recipients for enrollment into Government Programs such as Medicaid/Medicaid Managed Care, Child Health Plus and Essential Plan. Additionally, the MFE will assist in enrollment into Qualified Health Plans. The MFE must offer all plans and all products. MFEs assist families with their applications, provides assistance with completing the application, gathers the necessary documentation, and assists in selection of the appropriate health plan. The Enroller provides information on managed care programs and how to access care. The MFE is responsible for processing paperwork completely and accurately, including follow up visit documentation and other necessary reports. The MFE is also responsible for assisting current members with recertification with their plan. MFEs must source, develop and maintain professional, congenial relationships with local community agencies as well as county and state agency personnel who refer potentially eligible recipients. KNOWLEDGE/SKILLS/ABILITIES * Responsible for achieving monthly, quarterly, and annual enrollment goals and growth targets, as established by management. * Interview, screen and assist potentially eligible recipients with the enrollment process into Medicaid/Medicaid Managed Care, Child Health Plus the Essential Plan and Qualified Health Plans for Molina and other plans who operate in our service area * Meet with consumers at various sites throughout the communities * Provide education and support to individuals who are navigating a complex system by assisting consumers with the application process, explaining requirements and necessary documentation * Identify and educate potential members on all aspects of the plan including answering questions regarding plan's features and benefits and walking client through the required disclosures * Educate members on their options to make premium payments, including due dates * Assist clients with choosing a plan and primary care physician * Submit all completed applications, adhering to submission deadline dates as imposed by NYSOH and Molina enrollment guidelines and requirements * Responsible for identifying and assisting current members who are due to re-certify their healthcare coverage by completing the annual recertification application including adding on additional eligible family members * Respond to inquiries from prospective members and members within the marketing guidelines * Must adhere to all NYSOH rules and regulations as applicable for MFE functions * Outreach Projects * Participate in events and community outreach projects to other agencies as assigned by Management for a minimum of 8 hours per week * Establish and maintain good working relationships with external business partners such as hospital and provider * organizations, city agencies and community-based organizations where enrollment activities are conducted * Develop and strengthen relations to generate new opportunities * Attend external meetings as required * Attend community health fairs and events as required * Occasional weekend or evening availability for special events. JOB QUALIFICATIONS Required Education HS Diploma Required Experience * Minimum one year of experience working with State and Federal Health Insurance programs and populations * Demonstrated organizational skills, time management skills and ability to work independently * Ability to meet deadlines * Excellent written and oral communication skills; strong presentation skills * Basic computer skills including Microsoft Word and Excel * Strong interpersonal skills * A positive attitude with ability to adapt to change * Must have reliable transportation and a valid NYS drivers' license with no restrictions * Knowledge of Managed Care insurance plans * Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities * Ability to work a flexible schedule, including nights and weekends Required License, Certification, Association Successful completion of the NYSOH required training, certification and recertification Preferred Education AA/AS - Associates degree Preferred Experience Previous experience as a Marketplace Facilitated Enroller • Bilingual - Spanish & English 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 Opportunity Employer (EOE) M/F/D/V. #PJED #LI-AC1 Pay Range: $18.04 - $42.2 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides support for claims audit activities including identification of incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and claims processing errors. + Audits the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing of claims errors. + Prepares, tracks and provides claims audit findings reports according to established timelines. + Presents claims audit findings and makes recommendations to leadership for improvements based on audit results. + Reviews timeliness of claims processing to ensure compliance with contractual and state/federal requirements. + Maintains minimum claims audit accuracy rate per contractual guidelines. + Supports claims department initiatives to improve overall claims function efficiency. + Meets claims audit department quality and production standards. + Completes basic claims projects as assigned. + Experience in reviewing high $ claims, claims payment method. **Required Qualifications** + At least 2 years of experience in a clerical role in a claims, and/or customer service setting - preferably in managed care, or equivalent combination of relevant education and experience. + Audit, research, and data entry skills. + Organizational skills and attention to detail. + Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. + Customer service experience. + Effective verbal and written communication skills. + Microsoft Office suite and applicable software programs proficiency. **Preferred Qualifications** + Health care claims auditing/billing experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $18.35 - $42.2 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Responsible for all information technology operations activities, including computer operations, data and operations support. Monitor budgets and expenses within department and accountable for meeting budget goals. Recommends input to policy principles and budget constraints. Provides expertise to departments regarding policies and procedures, problem resolution, and methods. KNOWLEDGE/SKILLS/ABILITIES * Analyzes, reviews and measures service level performance against agreed upon service level agreements (Service Level Agreements) with the business and operating-level agreements with service providers (internal and external). * Works closely with the business and service providers to negotiate and agree on service level requirements off any proposed new services and changes to existing services. * Works with the business and service providers to define the proper metrics and KPIs in evaluating service delivery quality and performance levels. Produces regular reports on service performance and achievement to stakeholders. * Organizes and maintains the service level review process with the business and service providers. Initiates any actions required to maintain or improve service levels. * Acts as a change agent to implement and manage quality improvement processes in service delivery management. JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent combination of education and experience Required Experience 5-7 years Preferred Education Graduate Degree or equivalent combination of education and experience Preferred Experience 7-9 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 Opportunity Employer (EOE) M/F/D/V Pay Range: $80,412 - $188,164 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

JOB DESCRIPTION Job SummaryProvides support for medical records collection activities. Supports quality improvement activities through outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records. * Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. * Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. * Provides project management support to leadership via coordination, identification, pursuit and collection of medical records and other required data with other HEDIS staff. * Participates in meetings with vendors related to the medical record collection process. * Some medical records collection related travel may be required. Required Qualifications• At least 1 year customer service experience, preferably in an administrative support capacity in a health care setting, or equivalent combination of relevant education and experience. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. * Excellent customer service and active listening skills. * Proficiency with data analysis tools (e.g., Excel). * Ability to manage files, schedules and information efficiently. * Ability to effectively interface with staff, clinicians, and leadership. * Strong prioritization skills and detail orientation. * Strong verbal and written communication skills, including professional phone etiquette. * Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications * Registered Health Information Technician (RHIT). * Medical records collection experience. * Managed care experience. * Basic knowledge of Healthcare Effectiveness Data Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). * Project planning experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $31.71 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides program management and strategic oversight for provider engagement, quality improvement, and risk adjustment initiatives. The position is responsible for planning, coordinating, and monitoring cross-functional programs that support regulatory compliance, quality performance, and accurate risk adjustment outcomes. Working closely with internal stakeholders and external partners. The role analyzes performance data, tracks initiatives, manages deliverables, and drives continuous improvement to support value-based care and improved member outcomes. **Job Duties** + Responsible for driving provider performance and partnership across provider engagement, quality improvement, and risk adjustment initiatives + Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective program. + Performs analysis of performance data and implement improvement strategies that support Value-Based Care, Quality, Risk Adjustment, Provider Engagement, and positive member health outcomes. + Manages program budget, as applicable, supporting project prioritization. + Collaborates with Legal, Compliance, and Information Security to ensure governance standards are upheld. + Tracks performance metrics and ensures value realization from deployed solutions. + Coordinates recurring meetings to support governance framework and decision-making processes, as needed. + At the direction of program (CoE, Shared Service or other functional area) leadership, supports portfolio management and/or initiative-specific change and project management. + Collaborates with key stakeholders to support dissemination and adoption of program guardrails, processes, best practices and other collateral. + Routinely reviews program collateral to ensure current and accurate reflection of business needs. + Identifies opportunities/gaps and provides recommendations on program enhancements to respective leadership team. + Responsible for creating business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations. + Generates and distributes standard reports on schedule. **JOB QUALIFICATIONS** **REQUIRED QUALIFICATIONS** : + At least 4 years of Program and/or Project management experience, or equivalent combination of relevant education and experience. + Operational Process Improvement experience. + Managed Care experience, preferably in a shared service, CoE or matrixed environment. + Experience with Microsoft Project and Visio. + Strong presentation and communication skills. **PREFERRED EXPERIENCE** : + Understanding of healthcare provider engagement or payer-provider program management. + Experience working in managed care, health plans, or healthcare networks (Medicaid, Medicare, Marketplace). + Knowledge of state and federal healthcare regulations, including CMS and Medicaid requirements. + Familiarity with clinical, quality, or risk adjustment program workflows. + Understanding of HEDIS, CAHPS, STAR Ratings, and quality benchmarking methodologies. + Ability to interpret healthcare data and translate insights into program improvements. + Experience tracking KPIs, closure rates, and program performance metrics. + Detail-oriented with strong follow-through and accountability. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $129,590 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

(Sales) Compliance Analyst Molina Healthcare's Medicare Compliance team supports sales operations for the Molina Medicare product lines. It is a centralized corporate function supporting compliance activities. KNOWLEDGE/SKILLS/ABILITIES is primarily responsible for Sales Oversight. * Provide regulatory expertise to the Sales Organization: both State and Federal * Have working knowledge of federal and state guidelines pertaining to Sales and Marketing. * Perform internal Sales/Marketing Compliance Reporting. * Perform internal Sales/Marketing monitoring. * Detailed oriented to conduct thorough Sales allegations investigations. * Recommend applicable corrective action(s) when applicable to business partners. * Process improvement driven. * Create, update, and retire P&Ps, Standard Operating Procedures and Training documents. * Lead regularly scheduled Sales & Compliance leadership meetings. * Interpret and analyze Medicare, Medicaid, and MMP Required Sales & Marketing Reporting Technical Specifications. * Create and maintain monthly and quarterly Sales Complaint Key Performance Indicator (KPI) reports. * Review and interpret internal Sales dashboards for outliers and deeper dive research. * Manage compliance Sales Allegations, Secret Shops, and recommend corrective action plans for deficiencies found. * Responds to legislative inquiries/ Sales complaints (state insurance regulators, Congressional, etc.). * Leads projects to achieve Sales compliance objectives. * Interprets and analyzes state and federal regulatory manuals and revisions. * Interpret and analyze federal and state rules and requirements for proposed & final rules for Sales Oversight. * Interact with Molina external customers, via verbal and written communication. * Ability to work independently and set priorities. Experience * 2-4 years' related compliance work experience * Exceptional communication skills, including presentation capabilities, both written and verbal. * Excellent interpersonal communication and oral and written communication skills. * High level Interaction with Leadership. * Sales Allegation Investigations * Policy & Procedures Pay Range: $80,168 - $116,835 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: * Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; * Help meet or exceed applicable access criteria and adequacy standards for covered services; * Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and * Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' Knowledge/Skills/Abilities * Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. * Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. * Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). * Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. * Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. * Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates. * Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. * Works with assigned national vendors to improve contractual terms and maintain positive relationships. * Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. * Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. * Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). * Helps develop and utilize standardized contract templates and Pay for Performance strategies. * Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. Job Qualifications Required Education Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. Required Experience 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. Required License, Certification, Association N/A Preferred Education Master's Degree Preferred Experience 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. Preferred License, Certification, Association N/A 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 Opportunity Employer (EOE) M/F/D/V. Pay Range: $107,028 - $250,446 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Work Schedule: Part time, 25 to 28 hours a week Fridays and Sundays are mandatory Sundays 2pm to 10:30pm Fridays 2pm to 10:30pm Then either a 2pm to 10:30pm or 6pm to 10:30pm shift a few more nights throughout the week Pay: $18.00/hour plus $1.00/hour shift differential Key Responsibilities: Pick, pack and ship prescriptions directly to retail pharmacies and end-customer in a fast-paced semi-automated production environment. Ability to fill, pack and ship prescriptions with 100% accuracy and efficiency using Standard Operating Procedures (SOP) and McKesson supported hardware and software. Able to read computer generated screens, find indicated merchandise on labeled shelves, and verify quantity and dosage of the product before selecting for order. Examines stock and distributes materials in inventory. Also responsible for maintenance and housekeeping, proper storage of goods, ensuring correct reliable shelf labels for merchandise locations, and other duties as assigned. May require mandatory overtime based on business need. Minimum Requirements: Typically requires 1+ years of related experience Critical Skills: 0-1 years of proven experience with excellent attention to detail 0-1 years' experience in a quality focused role Additional Qualifications/Job Information: Excellent attention to detail Quality focused Physical Requirements: Able to select and lift objects from shelves and carry to order filling line. Able to consistently carry 20-30 lbs. of merchandise short distances and 15 lbs. of merchandise on an extended basis from order filling station to conveyor. Must be able to walk and stand throughout the entire shift. Internal Applicants: Must meet established attendance requirements. Must not currently be on progressive discipline - written or final written warning. Must currently maintain acceptable standards and quality in present position. Current McKesson employee who has completed 90 day probationary period . Please note if you are still on your probationary period and are interested in this position please see your supervisor, if no internal candidates whom have completed their probation apply then you may put in a internal application for consideration. We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here. McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!

Provides lead level support in the execution of merger and acquisition transactions and actively contributes to the advancement of Molina Healthcare's overall growth strategy. Duties include strategically identifying, sourcing, evaluating, and executing Molina Healthcare's inorganic growth initiatives, including acquisitions, divestitures, joint ventures, and strategic partnerships. Collaborates closely with Molina Healthcare's Mergers and Acquisitions (M&A) and operational leadership to evaluate and execute meaningful growth initiatives. Job Duties * Partners with internal stakeholders to research and assess potential acquisition opportunities. * Develops financial and valuation models and perform comprehensive analyses to assess potential transaction opportunities and influence decision-making. * Coordinates all aspects of the M&A process, including due diligence, data rooms, transaction documents, internal updates, and senior management/board presentations. * Coordinates deal activities among internal cross-functional teams and external parties. * Embraces ad-hoc assignments and projects across Corporate Development and in support of post-acquisition integration efforts. * Actively participates in reviewing and negotiating transaction agreements. * Establishes a robust understanding of customer segments, industry trends, market positioning, and emerging opportunities. Required Qualifications * At least 5 years' experience in investment banking, private equity, management consulting, corporate development, or similar environments, or equivalent combination of relevant education and experience * Exceptional financial modeling, interpersonal, and project management skills. * Attention to detail. Strong work ethic. Proactive self-starter. Calm under pressure. Able to adapt to fast-paced, ambiguous environments. High learning agility. Consummate teammate. * Excellent written communication skills. Strong spoken communication skills. Preferred Qualifications * Bachelor's degree in Finance, Economics, Mathematics, or a similar field. * Previous healthcare experience To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides support for pharmacy technician activities. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: (11 AM-7:30 PM MST or 12:30-9 PM MST) Essential Job Duties * Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests. * Accurately enters approvals or denials of requests. * Facilitates prior authorization requests within established pharmacy policies and procedures. * Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices. * Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership. * Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues. * Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed. Required Qualifications * At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience. * Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. * Ability to abide by Molina policies. * Ability to maintain attendance to support required quality and quantity of work. * Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA). * Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers. * Excellent verbal and written communication skills. * Microsoft Office suite (including Excel), and applicable software program(s) proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $31.71 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.