Molina Healthcare jobs in Irving, TX - 2323 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.

HealthTrust Workforce Solutions Regional is seeking a local contract CT Technologist for a local contract job in Dallas, Texas. Job Description & Requirements Specialty: CT Technologist Discipline: Allied Health Professional Duration: 13 weeks 36 hours per week Shift: 12 hours, days, nights Employment Type: Local Contract Entrust Your Career to HealthTrust Join one of the leading hospital organizations! Our partnering facility is seeking a highly-skilled caregiver to join their care team. The successful candidate is expected to be experienced in their area of specialty and offer a wide variety of high-level skills such as critical thinking and time management. For our local contract assignments, HealthTrust offers: Base pay (with potential weekend and night differentials if applicable to your specialty/geographic area) Guaranteed hours Weekly direct deposit 401k Quarterly bonus options for 468 hours worked Earn up to $1000 for referrals HWS GO mobile app for visibility to per diem and other open contract roles About HealthTrust Workforce Solutions: HealthTrust is a preferred partner to thousands of top-performing hospitals, we provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. Apply Today! Not for You? Reach out to learn more about our Refer a Friend opportunity and Earn up to $1000. Have Questions? Live Chat with a Recruiter: (enter your direct number here) We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

HealthTrust Workforce Solutions Regional is seeking a local contract Cath Lab Technologist for a local contract job in Arlington, Texas. Job Description & Requirements Specialty: Cath Lab Technologist Discipline: Allied Health Professional Duration: 13 weeks 36 hours per week Shift: 12 hours, days Employment Type: Local Contract Entrust Your Career to HealthTrust Join one of the leading hospital organizations! Our partnering facility is seeking a highly-skilled caregiver to join their care team. The successful candidate is expected to be experienced in their area of specialty and offer a wide variety of high-level skills such as critical thinking and time management. For our local contract assignments, HealthTrust offers: Base pay (with potential weekend and night differentials if applicable to your specialty/geographic area) Guaranteed hours Weekly direct deposit 401k Quarterly bonus options for 468 hours worked Earn up to $1000 for referrals HWS GO mobile app for visibility to per diem and other open contract roles About HealthTrust Workforce Solutions: HealthTrust is a preferred partner to thousands of top-performing hospitals, we provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. Apply Today! Not for You? Reach out to learn more about our Refer a Friend opportunity and Earn up to $1000. Have Questions? Live Chat with a Recruiter: (enter your direct number here) We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

HealthTrust Workforce Solutions Regional is seeking a local contract nurse RN PCU - Progressive Care Unit for a local contract nursing job in Plano, Texas. Job Description & Requirements Specialty: PCU - Progressive Care Unit Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours, days, evenings, nights, flexible, rotating Employment Type: Local Contract Entrust Your Career to HealthTrust Join one of the leading hospital organizations! Our partnering facility is seeking a highly-skilled caregiver to join their care team. The successful candidate is expected to be experienced in their area of specialty and offer a wide variety of high-level skills such as critical thinking and time management. For our local contract assignments, HealthTrust offers: Base pay (with potential weekend and night differentials if applicable to your specialty/geographic area) Guaranteed hours Weekly direct deposit 401k Quarterly bonus options for 468 hours worked Earn up to $1000 for referrals HWS GO mobile app for visibility to per diem and other open contract roles About HealthTrust Workforce Solutions: HealthTrust is a preferred partner to thousands of top-performing hospitals, we provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. Apply Today! Not for You? Reach out to learn more about our Refer a Friend opportunity and Earn up to $1000. Have Questions? Live Chat with a Recruiter: (enter your direct number here) We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

HealthTrust Workforce Solutions Local is seeking a per diem / prn Speech Language Pathologist for a per diem / prn job in Dallas, Texas. Job Description & Requirements Specialty: Speech Language Pathologist Discipline: Therapy Duration: Ongoing Employment Type: Per Diem Posted rates reflects the maximum rate, including night and weekend shift differentials Entrust Your Career to HealthTrust! At HealthTrust, we believe that healthcare is not defined by the four walls in which it is practiced; it's defined by its people. We pride ourselves on crafting opportunities that expand skill sets, broaden career horizons, provide economic stability, and cultivate personal growth. HealthTrust Offers: Getting to know HCA facilities within 50mi of home zip code Self scheduling through our Mobile GO HWS App Minimum of just three shifts a month, however, you can work more! 401K Matching Weekly pay every Friday Not required to work weekends Not Required to work holidays To get started, you will need: RN's a minimum of 1 year in specialty Allied 6 months of experience An adventurous spirit and fierce dedication Degree in corresponding specialty as required Appropriate certifications for the specific position HealthTrust Benefits: Opportunities for a lifetime: When you become a part of the HCA family, you will have exclusive access to more opportunities than any other healthcare system in the nation. At HWS, we help open the door to a lifetime of lasting career opportunities. A culture of care: Our clinicians have made HWS an industry leader for over 25 years. We are passionate about our mission that, above all else, we are committed to the care and improvement of human life. Career Development: As a wholly owned subsidiary of HCA Healthcare, HWS is a preferred partner to thousands of top-performing hospitals. We provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. We are uniquely positioned to offer you exclusive and direct access to HCA Healthcare's vast network of facilities. Let us open the door to nationwide opportunities that fit your lifestyle! We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Job Requirements Certifications ASHA (Required) BLS (Required) HealthTrust Workforce Solutions Per Diem Job ID #918298. Posted job title: Per Diem Speech Language Pathologist - General - SLP

HealthTrust Workforce Solutions Local is seeking a per diem / prn nurse RN Post Partum for a per diem / prn nursing job in Dallas, Texas. Job Description & Requirements Specialty: Post Partum Discipline: RN Duration: Ongoing Employment Type: Per Diem Posted rates reflects the maximum rate, including night and weekend shift differentials Entrust Your Career to HealthTrust! At HealthTrust, we believe that healthcare is not defined by the four walls in which it is practiced; it's defined by its people. We pride ourselves on crafting opportunities that expand skill sets, broaden career horizons, provide economic stability, and cultivate personal growth. HealthTrust Offers: Getting to know HCA facilities within 50mi of home zip code Self scheduling through our Mobile GO HWS App Minimum of just three shifts a month, however, you can work more! 401K Matching Weekly pay every Friday Not required to work weekends Not Required to work holidays To get started, you will need: RN's a minimum of 1 year in specialty Allied 6 months of experience An adventurous spirit and fierce dedication Degree in corresponding specialty as required Appropriate certifications for the specific position HealthTrust Benefits: Opportunities for a lifetime: When you become a part of the HCA family, you will have exclusive access to more opportunities than any other healthcare system in the nation. At HWS, we help open the door to a lifetime of lasting career opportunities. A culture of care: Our clinicians have made HWS an industry leader for over 25 years. We are passionate about our mission that, above all else, we are committed to the care and improvement of human life. Career Development: As a wholly owned subsidiary of HCA Healthcare, HWS is a preferred partner to thousands of top-performing hospitals. We provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. We are uniquely positioned to offer you exclusive and direct access to HCA Healthcare's vast network of facilities. Let us open the door to nationwide opportunities that fit your lifestyle! We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Job Requirements Certifications NRP (Required) BLS (Required) HealthTrust Workforce Solutions Per Diem Job ID #925452. Posted job title: Per Diem Nurse - Postpartum

Introduction Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Medical Assistant - X-Ray McKinney TX today with Texas Joint Institute. Benefits Texas Joint Institute offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and financial wellbeing * 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) * Employee Stock Purchase Plan with 10% off HCA Healthcare stock * Family support through fertility and family building benefits with Progyny and adoption assistance. * Referral services for child, elder and pet care, home and auto repair, event planning and more * Consumer discounts through Abenity and Consumer Discounts * Retirement readiness, rollover assistance services and preferred banking partnerships * Education assistance (tuition, student loan, certification support, dependent scholarships) * Colleague recognition program * Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) * Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. Come join our team as a(an) Medical Assistant - X-Ray McKinney TX. We care for our community! Just last year, HCA Healthcare and our colleagues donated 13.8 million dollars to charitable organizations. Apply Today! Job Summary and Qualifications Medical Assistant II Seeking a Clinical Medical Assistant II for our practice who provides clinical expertise to ensure all patients receive high quality, efficient care. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply now. * X-Ray Certification Required* DUTIES INCLUDE BUT NOT LIMITED TO: Scheduling and canceling patient appointments Checking-in and checking-out patients Entering charges and payments Answering the telephone Verifying patient insurance and demographics Collection of co-payments/coinsurance and personal balances 7. Performs selected administrative duties and assists nursing staff. May collect patient specimens. Takes patient histories and vital signs. Prepares exam and treatment rooms with necessary instruments. Gives injections, and applies casts, splints, and dressings, as applicable. Prepares and maintain supplies and equipment for treatments, including sterilization. Assists physician in preparing for minor surgeries and physicals. Perform other duties as required. Must read, understand, and adhere to all Physician Services policies and procedures. Practice and adhere to the Code of Conduct and Mission and Value Statement. Practices certified as Patient Center Medical Home include these additional job duties: Coordinates continuity of patient care with external healthcare organizations and facilities and referrals from the primary care provider to a specialty care provider. Participates on a team for data collection, health outcomes reporting, audits and programmatic evaluation related to Patient Centered Medical Home. EXPERIENCE: One year of Medical Assisting or other direct clinical patient care experience in a healthcare setting. CERTIFICATION/LICENSE: Medical Assistant Certification - required. Acceptable certifications are RMA, CCMA, CMA, NCMA, or NCRMA certification/ABR-OE credentials is acceptable OR Medical Assistants who recently graduated (within the last 12 months) from a Medical Assisting training program must obtain Medical Assistant certification within 60 days of employment. OR Candidates/incumbents with one year of Medical Assistant work experience who do not possess Medical Assistant Certification must obtain Medical Assistant Certification within one year of hire date. Possession of active and unrevoked x-ray certification is required upon hire Supporting HCA Healthcares 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in costs for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "The great hospitals will always put the patient and the patients family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Medical Assistant - X-Ray McKinney TX opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today! We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

HealthTrust Workforce Solutions Local is seeking a per diem / prn nurse RN ICU - Intensive Care Unit for a per diem / prn nursing job in Dallas, Texas. Job Description & Requirements Specialty: ICU - Intensive Care Unit Discipline: RN Duration: Ongoing Employment Type: Per Diem Posted rates reflects the maximum rate, including night and weekend shift differentials Entrust Your Career to HealthTrust! At HealthTrust, we believe that healthcare is not defined by the four walls in which it is practiced; it's defined by its people. We pride ourselves on crafting opportunities that expand skill sets, broaden career horizons, provide economic stability, and cultivate personal growth. HealthTrust Offers: Getting to know HCA facilities within 50mi of home zip code Self scheduling through our Mobile GO HWS App Minimum of just three shifts a month, however, you can work more! 401K Matching Weekly pay every Friday Not required to work weekends Not Required to work holidays To get started, you will need: RN's a minimum of 1 year in specialty Allied 6 months of experience An adventurous spirit and fierce dedication Degree in corresponding specialty as required Appropriate certifications for the specific position HealthTrust Benefits: Opportunities for a lifetime: When you become a part of the HCA family, you will have exclusive access to more opportunities than any other healthcare system in the nation. At HWS, we help open the door to a lifetime of lasting career opportunities. A culture of care: Our clinicians have made HWS an industry leader for over 25 years. We are passionate about our mission that, above all else, we are committed to the care and improvement of human life. Career Development: As a wholly owned subsidiary of HCA Healthcare, HWS is a preferred partner to thousands of top-performing hospitals. We provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. We are uniquely positioned to offer you exclusive and direct access to HCA Healthcare's vast network of facilities. Let us open the door to nationwide opportunities that fit your lifestyle! We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Job Requirements Certifications ACLS (Required) NIHSS (Required) BLS (Required) HealthTrust Workforce Solutions Per Diem Job ID #913986. Posted job title: Per Diem Nurse - Critical Care

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.

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.

HealthTrust Workforce Solutions Local is seeking a per diem / prn Radiology Technologist for a per diem / prn job in Dallas, Texas. Job Description & Requirements Specialty: Radiology Technologist Discipline: Allied Health Professional Duration: Ongoing Employment Type: Per Diem Posted rates reflects the maximum rate, including night and weekend shift differentials Entrust Your Career to HealthTrust! At HealthTrust, we believe that healthcare is not defined by the four walls in which it is practiced; it's defined by its people. We pride ourselves on crafting opportunities that expand skill sets, broaden career horizons, provide economic stability, and cultivate personal growth. HealthTrust Offers: Getting to know HCA facilities within 50mi of home zip code Self scheduling through our Mobile GO HWS App Minimum of just three shifts a month, however, you can work more! 401K Matching Weekly pay every Friday Not required to work weekends Not Required to work holidays To get started, you will need: RN's a minimum of 1 year in specialty Allied 6 months of experience An adventurous spirit and fierce dedication Degree in corresponding specialty as required Appropriate certifications for the specific position HealthTrust Benefits: Opportunities for a lifetime: When you become a part of the HCA family, you will have exclusive access to more opportunities than any other healthcare system in the nation. At HWS, we help open the door to a lifetime of lasting career opportunities. A culture of care: Our clinicians have made HWS an industry leader for over 25 years. We are passionate about our mission that, above all else, we are committed to the care and improvement of human life. Career Development: As a wholly owned subsidiary of HCA Healthcare, HWS is a preferred partner to thousands of top-performing hospitals. We provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. We are uniquely positioned to offer you exclusive and direct access to HCA Healthcare's vast network of facilities. Let us open the door to nationwide opportunities that fit your lifestyle! We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Job Requirements Certifications ARRT (Required) BLS (Required) HealthTrust Workforce Solutions Per Diem Job ID #918456. Posted job title: Per Diem Radiology Tech - General - Radiology Tech

JOB DESCRIPTIONJob 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. 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 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.

HealthTrust Workforce Solutions Regional is seeking a local contract Cath Lab Technologist for a local contract job in Fort Worth, Texas. Job Description & Requirements Specialty: Cath Lab Technologist Discipline: Allied Health Professional Duration: 13 weeks 36 hours per week Shift: 12 hours, days Employment Type: Local Contract Entrust Your Career to HealthTrust Join one of the leading hospital organizations! Our partnering facility is seeking a highly-skilled caregiver to join their care team. The successful candidate is expected to be experienced in their area of specialty and offer a wide variety of high-level skills such as critical thinking and time management. For our local contract assignments, HealthTrust offers: Base pay (with potential weekend and night differentials if applicable to your specialty/geographic area) Guaranteed hours Weekly direct deposit 401k Quarterly bonus options for 468 hours worked Earn up to $1000 for referrals HWS GO mobile app for visibility to per diem and other open contract roles About HealthTrust Workforce Solutions: HealthTrust is a preferred partner to thousands of top-performing hospitals, we provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. Apply Today! Not for You? Reach out to learn more about our Refer a Friend opportunity and Earn up to $1000. Have Questions? Live Chat with a Recruiter: (enter your direct number here) We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Provides lead level analyst support for configuration information management activities. Responsible for accurate and timely implementation and maintenance of critical information on claims databases, synchronizing operational and claims systems data and application of business rules as they apply to each database, validating data to be housed on databases, and ensuing adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements. **Essential Job Duties** - Analyzes and interprets data to determine appropriate configuration changes. - Accurately interprets specific state and/or federal benefits, in addition to other business requirements, and converts terms to configuration parameters. - Manages coding, updating and maintaining benefit plans, provider contracts, fee schedules and various system tables in the user interface. - Applies experience and knowledge to research and resolve claim/encounter issues and pended claims, and updates system(s) as necessary. - Loads and maintains contracts, benefit and/or reference table information into the claims payment system and other applicable systems. - Participates in defect resolution for assigned component(s). - Participates in the implementation and conversion of new and existing health plans. - Assists in planning and coordination of application upgrades and releases, including development and execution of some test plans. - Assists with development of configuration standards and best practices, and suggests improvement processes to ensure systems are working efficiently and enhance quality. - Creates reporting tools to enhance communication on configuration updates and initiatives. - Negotiates expected configuration information management completion dates with health plans. - Collaborates with internal and external stakeholders to understand business objectives and processes. - Solutions with health plans and corporate functions to ensure all end-to-end business requirements have been documented. - Assists leadership in establishing standards, guidelines, and best practices for the configuration information management team. - Represents as a departmental configuration information management subject matter expert. - Supports various department-wide configuration information management projects. - Provides training and support to new and existing configuration information management team members, including configuration functionality, enhancements and updates - Manages fluctuating volumes of work, and prioritizes work to meet deadlines and needs of the configuration department and user community. **Required Qualifications** + At least 5 years of configuration information management experience maintaining databases, and/or analyst experience within a health care operations setting in a managed care organization supporting Medicaid, Medicare, and/or Marketplace programs, or equivalent combination of relevant education and experience. + Must have Contract configuration experience in Networx. + Experience with QNXT is preferred. + Advanced experience using a claims processing system. + Advanced experienced verifying documentation related to updates/changes within a claims processing system. + Advanced experience validating and confirming information related to provider contracting, network management, credentialing, benefits, prior authorizations, fee schedules, and other business requirements. + Analytical and critical-thinking skills. + Flexibility to meet changing business requirements, and commitment to high-quality/on-time delivery + High attention to detail. + Effective verbal and written communication skills. + Microsoft Office suite proficiency, including intermediate to advanced Excel abilities (VLOOKUP/Pivot Tables, etc.), 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: $80,168 - $155,508 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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.

**(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.

HealthTrust Workforce Solutions Local is seeking a per diem / prn nurse RN Med Surg for a per diem / prn nursing job in Arlington, Texas. Job Description & Requirements Specialty: Med Surg Discipline: RN Duration: Ongoing Employment Type: Per Diem Posted rates reflects the maximum rate, including night and weekend shift differentials Entrust Your Career to HealthTrust! At HealthTrust, we believe that healthcare is not defined by the four walls in which it is practiced; it's defined by its people. We pride ourselves on crafting opportunities that expand skill sets, broaden career horizons, provide economic stability, and cultivate personal growth. HealthTrust Offers: Getting to know HCA facilities within 50mi of home zip code Self scheduling through our Mobile GO HWS App Minimum of just three shifts a month, however, you can work more! 401K Matching Weekly pay every Friday Not required to work weekends Not Required to work holidays To get started, you will need: RN's a minimum of 1 year in specialty Allied 6 months of experience An adventurous spirit and fierce dedication Degree in corresponding specialty as required Appropriate certifications for the specific position HealthTrust Benefits: Opportunities for a lifetime: When you become a part of the HCA family, you will have exclusive access to more opportunities than any other healthcare system in the nation. At HWS, we help open the door to a lifetime of lasting career opportunities. A culture of care: Our clinicians have made HWS an industry leader for over 25 years. We are passionate about our mission that, above all else, we are committed to the care and improvement of human life. Career Development: As a wholly owned subsidiary of HCA Healthcare, HWS is a preferred partner to thousands of top-performing hospitals. We provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. We are uniquely positioned to offer you exclusive and direct access to HCA Healthcare's vast network of facilities. Let us open the door to nationwide opportunities that fit your lifestyle! We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Job Requirements Certifications: BLS (Required) HealthTrust Workforce Solutions Per Diem Job ID #829648. Posted job title: Per Diem Nurse - Medical-Surgical

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.