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Molina Healthcare jobs in Los Angeles, CA - 234 jobs

  • Representative, Care Connections Member Advocate - Must Be Bilingual in Spanish. Mon - Fri 10:00 AM- 7:00 PM or Tues - Sat 7:00 AM- 4:00 PM Pacific Time Zone - CA ONLY

    Molina Healthcare Inc. 4.4company rating

    Molina Healthcare Inc. job in Los Angeles, CA

    Makes outbound calls to members, completes assigned hand-dial lists, and provides proactive member support, information, and assistance. Adheres to member interaction departmental standards, call quality, and documentation requirements. * Schedules high-quality member appointments daily to meet departmental goals. * Completes assigned hand-dial lists and member research requirements with accuracy and efficiency. * Provides basic support and guidance to members with empathy and professionalism. * Participates in ongoing training sessions to enhance service quality and knowledge. Job Qualifications REQUIRED QUALIFICATIONS: * At least 1 year experience in a healthcare service environment, or equivalent combination of relevant education and experience. * High attention to detail and ability to follow member interaction scripting. * Flexible and adaptive to changing priorities and workflows. * Compassionate and service oriented. * Bilingual (English and at least one additional language, as required). * Strong verbal and written communication skills. PREFERRED QUALIFICATIONS: * Healthcare administrative support experience in roles such as Medical Office Assistant, Patient Services Representative, Medical Receptionist, Front Desk Coordinator, or Scheduler. 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: $20.25 - $30.39 / 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.
    $20.3-30.4 hourly 57d ago
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  • Lead Investigator, Special Investigative Unit-(Kentucky)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    Under direct supervision of the Manager, SIU, the Team Lead is responsible to lead a small team of investigators and provide oversight on daily investigative activities as a back-up to the SIU Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight and guidance throughout the life of an investigation as well as QA reviews and approvals. In addition to leading a team of investigators and analysts, the Team Lead will ensure the Manager is aware of any major case developments, and ensure cases are being investigated according to the SIU's standards. Position must have thorough knowledge of Medicaid/Medicare/Marketplace health coverage audit policies and be able to apply them in ensuring program compliance via payment integrity programs. The position must have the ability to determine correct coding, documentation, potential fraud, abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare providers that bill Medicaid/Medicare/Marketplace. KNOWLEDGE/SKILLS/ABILITIES Ensure investigators are managing their cases effectively and in accordance with SIU policies, processes, quality standards, and procedures. Ensure that investigators are managing their respective State Reporting requirements and assignments effectively and timely. Manage the flow of day-to-day investigations. Perform assessment that QA measures were complete and signed-off Provide guidance to investigators as needed on investigative techniques, tools, or strategy. Effectively investigate and manage complex and non-complex fraud allegations. Develop and maintain relationships with key business units within specific product line and geographic region. Provides direction, instructions, and guidance to Investigative team, particularly in the absence of the SIU Manager. Provide training to team members as needed. Communicate clear instructions to team members, listen to team members' feedback. Monitor team members' participation to ensure the training provided is effective, and if any additional training is needed. Create, edit, and update assigned reports to apprise the company on the team's progress. Distribute reports to the appropriate personnel. JOB QUALIFICATIONS Required Education High School/GED Associates degree or bachelor's degree in Health Information Management, Health Care Administration, Finance, Criminal Justice, Law Enforcement, or related field (applicable FWA experience would be accepted in lieu of education experience) Required Experience Associates degree or bachelor's degree in Health Information Management, Health Care Administration, Finance, Criminal Justice, Law Enforcement, or related field (applicable FWA experience would be accepted in lieu of education experience) At least five (5) years' experience working in a Managed Care Organization or health insurance company Minimum of three (3) years' experience working on healthcare fraud related investigations/reviews Proven investigatory skill; ability to organize, analyze, and effectively determine risk with corresponding solutions; ability to remain objective and separate facts from opinions Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations Knowledge of Managed Care and the Medicaid and Medicare programs as well as Marketplace Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems Understanding of datamining and use of data analytics to detect fraud, waste, and abuse Proven ability to research and interpret regulatory requirements Effective interpersonal skills and customer service focus; ability to interact with individuals at all levels Excellent oral and written communication skills; presentation skills with ability to create and deliver training, informational and other types of programs Advanced skills in Microsoft Office (Word, Excel, PowerPoint, Outlook), SharePoint and Intra/Internet as well as proficiency with incorporating/merging documents from various applications Strong logical, analytical, critical thinking and problem-solving skills Initiative, excellent follow-through, persistence in locating and securing needed information Fundamental understanding of audits and corrective actions Ability to multi-task and operate effectively across geographic and functional boundaries Detail-oriented, self-motivated, able to meet tight deadlines Ability to develop realistic, motivating goals and objectives, track progress and adapt to changing priorities Energetic and forward thinking with high ethical standards and a professional image Collaborative and team-oriented Required License, Certification, Association Valid driver's license required. Preferred Experience Healthcare Anti-Fraud Associate (HCAFA), Accredited Health Care Fraud Examiner (AHFI) and/or Certified Fraud Examiner (CFE) preferred. 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. #PJCorp #LI-AC1
    $50k-80k yearly est. Auto-Apply 60d+ ago
  • Per Diem / PRN Nurse RN - NICU - Neonatal Intensive Care - $71 per hour

    Healthtrust Workforce Solutions Local 4.2company rating

    Thousand Oaks, CA job

    Per Diem / PRN Nurse RN - NICU - Neonatal Intensive Care - $71 per hour at HealthTrust Workforce Solutions Local summary: This position is for a per diem Registered Nurse specializing in Neonatal Intensive Care Unit (NICU) at HealthTrust Workforce Solutions, offering flexible scheduling and competitive hourly pay. Candidates must have at least one year of NICU experience, necessary certifications such as NRP and BLS, and the ability to self-schedule shifts through a mobile app. The role provides career development opportunities within HCA Healthcare's extensive hospital network and values diversity and inclusion in its workforce. HealthTrust Workforce Solutions Local is seeking a per diem / prn nurse RN NICU - Neonatal Intensive Care for a per diem / prn nursing job in Thousand Oaks, California. Job Description & Requirements Specialty: NICU - Neonatal Intensive Care Discipline: RN Start Date: Duration: Ongoing Employment Type: Per Diem 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 Night shifts are not required 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 #830961. Posted job title: Per Diem Nurse - Neonatal ICU (NICU) Keywords: NICU nurse, Neonatal Intensive Care, per diem nurse, Registered Nurse, RN NICU, Neonatal nursing, healthcare jobs, HCA Healthcare, nursing jobs California, critical care nurse
    $71 hourly 2d ago
  • Director, Quality Operations Distribution

    McKesson Corporation 4.6company rating

    Los Angeles, CA job

    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. The Director of Quality Operations, Distribution is responsible for leading all quality-related activities for wholesale distribution, 3PL, national brands, and government operations. This role ensures compliance with regulatory standards, drives continuous improvement, and fosters a culture of quality across the organization. The Director will oversee strategic planning, process improvements, quality control systems, and team leadership while collaborating with supply chain, customer service, category management, and sales teams. Key Responsibilities: Quality Assurance & Regulatory Oversight * Ensure regulatory and operational standards are established, executed, and monitored within distribution centers. * Oversee temperature monitoring and documentation for product storage areas. Investigation Leadership * Lead investigations into complaints and CAPA for product and process quality issues, including diversion and illegitimate products. Audit Preparation & Hosting * Prepare distribution centers for regulatory inspections and host external audits from suppliers and regulatory bodies. Data & Analytics * Develop and monitor KPIs, compile compliance reports, and provide recommendations for improvement. Compliance Training Resource * Act as a training resource for cGxP and ISO compliance; maintain up-to-date SOP training records. Minimum Qualifications: Education: Bachelor's degree or higher in Engineering, Science, or related field. Experience: * 10+ years in leadership roles within scientific fields or Quality Assurance in distribution or commercial manufacturing of medical devices/pharmaceuticals. * Clear understanding of cGxPs. * Experience leading FDA, Board of Pharmacy, and/or NABP inspections. Specialized Knowledge & Skills: * Expertise in regulatory requirements for distribution QA (CFR 205, 820, 210, 211, DSCSA, Hazmat, Cold Chain). * Strong verbal and written communication skills. * Organizational, problem-solving, and decision-making abilities. * Strategic thinking and change management skills. Working Conditions: * Traditional office environment. * Significant computer and phone-based work. Travel Requirements: * Up to 50% travel, including overnight and air travel. Compensation: * Estimated Salary Range: $140,000 - $180,000 annually (depending on experience and location). * Eligible for annual performance bonus and comprehensive benefits package including medical, dental, vision, 401(k), and paid time off. Additional Requirements: * Must be authorized to work in the U.S. * Sponsorship is not available for this position. Equal Opportunity Statement: McKesson is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status. Criminal history will not disqualify qualified applicants. Accommodation Notice: If you need a reasonable accommodation for your job search or application, please contact: Disability_Accommodation@McKesson.com. Resumes or CVs sent to this email will not be accepted. 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 $128,500 - $214,100 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!
    $140k-180k yearly Auto-Apply 60d+ ago
  • Program Administrator GME

    HCA 4.5company rating

    Thousand Oaks, CA job

    Salary Estimate: 63710.40 - 92414.40 / year Learn more about the benefits offered for this job. The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Job Summary and Qualifications The Graduate Medical Education (GME) Program Administrator is responsible for supporting the administrative, operational and financial management functions of the assigned residency/fellowship training program. The GME Program Administrator assists GME leaders in providing an optimal working and learning environment for all trainees. The position requires a comprehensive and detailed understanding of Accreditation Council for Graduation Medical Education (ACGME), hospital policies, as well as a high degree of initiative and independent judgment. The Program Administrator will continually assess and direct a wide range of programmatic issues including long range planning, recruiting trainees, onboarding trainees, developing projects, analyzing administrative workflow, maintaining databases, communicating with faculty and trainees regarding a range of issues, developing faculty and managing internal and external program relations. The Program Administrator supports the education design and leadership of the residency program, and therefore, shares responsibility for the residents, faculty and other colleagues within the program. What you will do in this role: * Manage the day-to-day operations of one or more residency or fellowship training programs. * Coordinate and organize program recruitment efforts and the National Resident Matching Program (NRMP) process. * Understand the program accreditation requirements and assist in ensuring compliance of the program, residents, and faculty with all applicable requirements. * Prepare and maintain all required program/resident documentation. * Coordinate program/resident onboarding and orientation processes. * Serve as the resident/fellow liaison to assure a positive educational experience. * Continuously assess and coordinate a wide range of programmatic events and processes, including curricular activities, onboarding and graduation, periodic assessment, budget planning and maintenance, annual Accreditation Council for Graduate Medical Education (ACGME) program updates and accreditation site visits, and more. What qualifications you will need: * Bachelor's degree preferred * Minimum 3 years of experience in a healthcare setting (preferably in Graduate Medical Education or in some field of education, i.e. teacher/educator) preferred * Training Administrators of Graduate Medical Education (TAGME) certification highly regarded * Knowledge of Residency Management Systems (MedHub or New Innovations) preferred * Proficiency with MS Word, Excel, PowerPoint, PDF software, online meeting platforms, email and other forms of electronic communication * Ability to efficiently and accurately manage multiple tasks and projects * Excellent written and verbal communication skills Benefits Los Robles Regional Medical Center 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. Our teams are a committed, caring group of colleagues. Do you want to work as a(an) Program Administrator GME where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise! 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. "Bricks and mortar do not make a hospital. People do."- 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 Program Administrator GME 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.
    $69k-90k yearly est. 48d ago
  • Local Contract Nurse RN - NICU - Neonatal Intensive Care - $76-78 per hour

    Healthtrust Workforce Solutions Regional 4.2company rating

    Thousand Oaks, CA job

    Local Contract Nurse RN - NICU - Neonatal Intensive Care - $76-78 per hour at HealthTrust Workforce Solutions Regional summary: This position is for a local contract Registered Nurse (RN) specializing in Neonatal Intensive Care Unit (NICU) nursing in Thousand Oaks, California. The role requires extensive experience with specialized neonatal equipment and procedures, including ventilator management, surgical bedside skills, and emergency care within a Level III NICU. Candidates must hold a valid CA RN license and relevant certifications such as BLS, PALS, and NRP, with preference for BSN degree holders and recent NICU experience. HealthTrust Workforce Solutions Regional is seeking a local contract nurse RN NICU - Neonatal Intensive Care for a local contract nursing job in Thousand Oaks, California. Job Description & Requirements Specialty: NICU - Neonatal Intensive Care Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours, days, nights Employment Type: Local Contract • Number of Beds - 12 • Number of Staff -day shift/12 night shift) • Type of staff: ALL RN only - Day Shift -Based on acuity & Number of patients: CNC/Charge + 2 RN (increase RN per acuities and number of patients) - Night Shift - Based on acuity & Number of patients: CNC/Charge + 2 RN (increase RN per acuities and number of patients) • Patient Ratios - 1:1; 1:2; 1:3 - Exchange transfusion 2:1 • Type of equipment - HFOV, SIMV, NIMV, CPAP, HFNC, Monitors, Alaris pump for IV; Medfusion or Medela for gavage feeds, Medela milk warmers; Phototherapy, Isolettes & radiant warmers, blood warmer; blanket warmer; Glucometer • EMR -Meditech for orders/labs and Medication/breastmilk and GE Centricity - CPN for nursing charting • Floating: Nursery & Pediatrics • Weekend/On Call: Every other weekend. Call if low census. • Must be able to: - Assist with intubations & capable to handle on ventilator and respiratory supportive equipment independently of RT in unit Assist with procedural & surgical bedside skills: UAC/UVC/PICC line placement & surgical procedures such as Broviac insertion; removal of cysts/growths in mouth/skin, circumcisions, etc. IV insertion proficiency Assist with ophthalmology examinations Assist with chest tube insertions and maintenance of equipment: chest tube drainage, collection, water seal, and suction devices Assist with Lumbar Punctures Phlebotomy skills to obtain lab specimens Insertion of ng/nj tubes and maintenance of equipment including knowledge of how to feed patient utilizing these supplies Independently insert NG/Salem sump to intermittent and continuous suction Wound & Ostomy care and supplies associated All nursing care related to a Level III NICU and Small Baby Protocol Comprehension how to use: Emergency ("code" or "crash") cart with emergency drugs with size/weight appropriate neonatal unit dose How and when to use a defibrillator Ability to assist with Exchange Transfusion: Including set up and calculations Competent in use of Usual & Customary NICU equipment independently Must Haves: - An ASN degree minimum, BSN preferred - A recent 12 months of NICU RN experience in an acute hospital setting - CA RN License - BLS, PALS, and NRP (AAP Advanced 9th edition) Certifications Preferred or Nice to Have: - Capable of attending high risk deliveries - MediTech Experience - Travel Experience Keywords: NICU nurse, neonatal intensive care, local contract nurse, registered nurse RN, NICU equipment, ventilator management, infant care, pediatric nursing, BLS PALS NRP certifications, acute hospital nursing
    $76-78 hourly 2d ago
  • Senior Facilitated Enroller (In Field Rochester, NY)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    The Senior Facilitated Enroller will use a high degree of customer service to successfully work with the team to provide optimal enrollment success. The Senior Facilitated Enroller (SFE) will assist the Facilitated Enrollment Supervisor in meeting and exceeding sites expectations and providing exceptional levels of customer service. The SFE will continue to assist eligible recipients for enrollment by phone or conduct face to face meetings. Assist the Facilitated Enrollment Supervisor in training, assisting with client meetings (webinars and leading meetings) and will be more involved with the Marketing Tracker and Salesforce. The SFE will also work closely with the Facilitated Enroller and will report to the Facilitated Enrollment Supervisor the successes or areas that require improvement and will provide input on strategy as the business needs change within given territory. Knowledge/Skills/Abilities Assists with inbound/outbound calls when necessary to assist FE with achieving monthly, quarterly and annual enrollment goals. The SFE will assist in leading FE and/or projects to help ensure monthly enrollment results. SFE will provide support across projects, including quality checks to Marketing Tracker and Sales Force. Works with Facilitated Enrollment Supervisor to successfully support FEs in enrollment success and to formulate resolutions for struggling FEs. Identifies any challenges and communicates to Facilitated Enrollment Supervisor. Successfully maintains and/or manages monthly FE calendar Excellent time management with the ability to maintain multi-faceted projects, providing both quality and quantity while completing job duties and adhering to various objectives with little to no supervision. Maintains a high level of professionalism to all outgoing emails to clients Shows a comprehensive understanding of processes, best practices, and indications with minor errors Monitors daily operations and identifies need for program tools and works with Facilitated Enroller Supervisor to meet staff needs. Participates in the design and implementation of process improvements within the current facilitated enrollment policies, procedures, services and workflow to improve the customer experience as well as productivity Maintains expert knowledge of current processes, rules and regulations of the MMC, EP, CHP and QHP programs and serves as a resource for implementation, training teams Offers suggestions to Facilitated Enrollment Supervisor regarding corrective action plans and conducts other quality activities to include policy and procedure review and application reviews Performs research assignments as directed by Facilitated Enrollment Supervisor which may include but are not limited to educational resources and best practices. Meets with consumers at various sites throughout the communities Provide education and support to individuals who are navigating a complex system by assisting consumers with application process, explaining requirements and necessary documentation Consistently demonstrates high standards of integrity by supporting Molina Healthcare of NY, Inc mission and values and adhering to the Corporate Code of Conduct Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures Performs other functions as assigned by management. Job Qualifications Required Education: High School Diploma or equivalence Required Experience: Minimum of 3 years of experience working with State and Federal Health Insurance programs and populations Demonstrated organizational skills, time management skills and ability to work independently Previous experience leading projects, processes, or teams Excellent written and oral communication skills; strong presentation skills Basic computer skills including Microsoft Word, Excel, Salesforce and Share Point Strong interpersonal, organizational skills and the ability to work in a team environment. A positive attitude with the ability to be flexible and adapt to change Knowledge of Managed Care insurance plans Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities Required Licensure or Certification: Must have reliable transportation and a valid NYS drivers' license with no restrictions Successful completion of the NYSOH required training, certification 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.
    $92k-124k yearly est. Auto-Apply 41d ago
  • Certified Sterile Processing Technician II PRN

    HCA 4.5company rating

    Thousand Oaks, CA job

    Hourly Wage Estimate: 24.99 - 34.98 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Introduction Do you have the PRN career opportunities as a Certified Sterile Proc Tech II PRN you want with your current employer? We have an exciting opportunity for you to join Thousand Oaks Surgical Hospital which is part of the nations leading provider of healthcare services, HCA Healthcare. Benefits Thousand Oaks Surgical Hospital, 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 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. * Fertility and family building benefits through Progyny * Free counseling services and resources for emotional, physical and financial wellbeing * Family support, including adoption assistance, child and elder care resources and consumer discounts * 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) * Employee Stock Purchase Plan * Retirement readiness and rollover 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) Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. Our teams are a committed, caring group of colleagues. Do you want to work as a Certified Sterile Proc Tech II PRN where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise! Job Summary and Qualifications As a Certified Sterile Processing Technician, you will play a critical role in protecting patient safety and supporting life-saving care through precision and attention to detail. In this rewarding role, you will be a vital part of our team - helping surgical staff deliver safe, effective care by ensuring every instrument and supply is clean, prepared, and ready when it is needed most. Your responsibilities will include: * Cleaning, inspecting, assembling, and sterilizing surgical instruments and trays to ensure they are sterile, complete, labeled, and ready for use * Managing sterilization equipment and keeping accurate records to support patient safety and infection prevention * Preparing customized surgical sets and case carts based on daily schedules and specific procedure needs * Managing inventory and supplies in OR storage and specialty lockers, working with the surgical team to meet needs and keep operations running smoothly * Responding quickly to instrument requests during surgeries and helping solve urgent equipment needs What qualifications you will need: * High School graduate or equivalent * Advanced knowledge of general surgical instruments and medical equipment preferred * A minimum of 2 years Central Service/Sterile Processing experience preferred * (CSPDT) Cert Sterile Processing and Distribution Technician, or (CRCST) Certified Registered Central Service Technician Required Los Robles Regional Medical Center is a 380+ bed acute care hospital dedicated to serving the residents of Ventura and Los Angeles Counties along with the Greater Conejo Valley. We are the only Level II Trauma Center in East Ventura County. We are known for providing excellent care with compassion and kindness to each of our patients. In addition, Los Robles Regional Medical Center features a 24-hour emergency department, comprehensive stroke center, ICU/CCU, maternity, Level III NICU, comprehensive cancer center, heart & cardiovascular center, same day surgery, and rehab center. 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 cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "Bricks and mortar do not make a hospital. People do."- 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 Certified Sterile Proc Tech II PRN opening. We review all applications. 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
    $51k-68k yearly est. 60d+ ago
  • Processor, Coordination of Benefits

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    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.
    $64k-101k yearly est. Auto-Apply 9d ago
  • Growth & Community Engagement Spc (McAllen TX Area)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    **Candidates for this position must live in or near the following areas, , McAllen, Mission, Edinburg, or Pharr Texas.** Are you passionate about serving your community? Do you have established relationships within the community? Come join our growing Community Engagement team at Molina Healthcare! Community Engagement is more than just participating in events-at Molina, we focus on making an impact on people's lives! This role involves working with a wide variety of community partners to grow Molina's membership and improve the health and well-being of the Community. Under limited supervision, you will be responsible for carrying out enrollment events and activities to help grow Molina Healthcare as the choice Medicaid provider in the community. You will do this by hosting and attending community events, delivering presentations, attending meetings, distributing educational materials, health fairs and more. This is a Field-Based position. You will be in the field engaging with CBO's (Community Based Organizations) 75% or more of the time (Molina reimburses mileage). This position offers great flexibility and allows for you to manage your territory and schedule to meet business needs. Knowledge of the Medicaid market. State Medicaid programs such as CHIP, STAR, and STAR PLUS programs highly desired. KNOWLEDGE/SKILLS/ABILITIES Responsible for achieving established goals improving Molina's enrollment growth objectives encompassing Medicaid programs. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages Under limited supervision, responsible for carrying out enrollment events and achieving assigned membership growth targets through a combination of direct and indirect marketing activities, with the primary responsibility of improving the plan's overall “choice” rate. Works collaboratively with other key departments to increase the Medicaid assignment percentage for Molina. Works closely with other team members and management to develop/maintain/deepen relationships with key business leaders, community-based organizations (CBOs) and providers, ensuring all efforts are directed towards building membership for Medicaid and related programs. Effectively moves relationships through the “enrollment” pipeline. Responsible for achieving monthly, quarterly, and annual enrollment goals, and growth and choice targets, as established by management. Schedules, coordinates & participates in enrollment events, encourages key partners to participate, and assists where feasible. Works cohesively with Provider Services to ensure providers within assigned territory are aware of Molina products and services. Establishes simple referral processes for providers and CBOs to refer clients who may be eligible for other Molina products. Viewed as a “subject matter expert” (SME) by community and influencers on the health care delivery system and wellness topics. Delivers presentations, attends meetings and distributes educational materials to both members and potential members. Assists with all incoming calls and assist perspective members or members with health access related questions. Identify partnerships with key sponsorship opportunities and provide justification to determine Molina's participation. Identify and promote Molina's programs out in the community and creates opportunities for employees to participate. Responsible for managing their own daily schedule in alignment with department goals and initiatives as assigned by regions. Key in the development of SMART goals and provide input on department priorities. **Candidates for this position must live in or near the following areas, McAllen, Mission, Edinburg, or Pharr Texas.** Bilingual (Spanish) Highly Desired JOB QUALIFICATIONS Required Education: Bachelor's Degree or equivalent, job-related experience. Preferred Education: Bachelor's Degree in Marketing or related discipline. Required Experience: Min. 3 years of related experience (e.g., marketing, business development, community engagement, healthcare industry). Demonstrated exceptional networking and negotiations skills. Demonstrated strong public speaking and presentations skills. Demonstrated ability to work in a fast-paced, team-oriented environment with little supervision. Must be able to attend public events in outdoor venues in all weather conditions. Must be able to sit and stand for long periods. Must be able to drive up to 3 hours to attend events. Must be able to lift 30 pounds. Required License, Certification, Association: Completion of Molina /DHS/MRMIB Marketing Certification Program/Covered CA Certified. Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation. Preferred Experience: Solid understanding of Health Care Markets, primarily Medicaid. Previous healthcare marketing, enrollment and/or grassroots/community outreach experience a plus. 5 years of outreach experience serving low-income populations. 3 - 5 years project management experience, preferably in a health care or outreach setting. Experience presenting to influencer and low-income audiences. Experience in sales or marketing techniques. Fluency in a second language highly desirable. Preferred License, Certification, Association: Active Life & Health Insurance Market Place Certified 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. Key Words: CHIP, STAR, Medicare, Medicaid, Star Plus, health coach, community health advisor, family advocate, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter and public health aide, community lead, community advocate, nonprofit, non-profit, social worker, case worker, housing counselor, human service worker, Navigator, Assistor, Connecter, Promotora, Marketing,
    $44k-86k yearly est. Auto-Apply 35d ago
  • Supervisor, Pharmacy Operations/Call Center

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    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
    $32k-39k yearly est. Auto-Apply 27d ago
  • Local Contract Echocardiography Technologist - $62 per hour

    Healthtrust Workforce Solutions Regional 4.2company rating

    Thousand Oaks, CA job

    HealthTrust Workforce Solutions Regional is seeking a local contract Echo Technologist for a local contract job in Thousand Oaks, California. Job Description & Requirements Specialty: Echo Technologist Discipline: Allied Health Professional Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Local Contract Number of Beds - 375 Number of Staff - 4 Type of staff: Day Shift - 4 Night Shift - ON- CALL Type of equipment - GE EMR - MEDITECH, CCW Typical Procedures: TEE Adult and Pediatric ECHO Structural Heart Procedure Support Intra-Op TEE with EP Procedures Stress ECHO Bubble Study Must Haves: - An Associates Degree - A recent 6 months of Echo Tech experience in an acute inpatient hospital setting - Adult and Pediatric Echo, TEE, Bubble Study, Structural Heart Procedures - RCS or RDCS and CA State License - BLS Certification Preferred or Nice to Have: - MediTech Experience - Travel Experience
    $63k-86k yearly est. 2d ago
  • Adjudicator, Provider Claims-On the phone

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    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
    $41k-53k yearly est. Auto-Apply 27d ago
  • Manager, Health Plan Provider Relations (Massachusetts)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    ***Employee for this role must reside in Massachusetts or surrounding state*** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and contracted provider network. In partnership with Director, manages and coordinates the Provider Services activities for the state health plan. Works with direct management, corporate, and staff to develop and implement standardized provider servicing and relationship management plans. Job Duties Manages the Plan's Provider Relations functions and team members. Responsible for the daily operations of the department working collaboratively with other operational departments and functional business unit stakeholders to lead or support various Provider Services functions with an emphasis on contracting, education, outreach and resolving provider inquiries. • In conjunction with the Director, Provider Network Management & Operations, develops health plan-specific provider contracting strategies, identifying specialties and geographic locations on which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of the Plan's patients or members. • Oversees and leads the functions of the external provider representatives, including developing and/or presenting policies and procedures, training materials, and reports to meet internal/external standards. • Manages and directs the Provider Service staff including hiring, training and evaluating performance. • Assists with ongoing provider network development and the education of contracted network providers regarding plan procedures and claim payment policies. • Develops and implements tracking tools to ensure timely issue resolution and compliance with all applicable standards. • Oversees appropriate and timely intervention/communication when providers have issues or complaints (e.g., problems with claims and encounter data, eligibility, reimbursement, and provider website). • Serves as a resource to support Plan's initiatives and help ensure regulatory requirements and strategic goals are realized. • Ensures appropriate cross-departmental communication of Provider Service's initiatives and contracted network provider issues. • Designs and implements programs to build and nurture positive relationships between contracted providers, ancillary providers, hospital facilities and Plan. • Develops and implements strategies to increase provider engagement in HEDIS and quality initiatives. • Engages contracted network providers regarding cost control initiatives, Medical Care Ratio (MCR), non-emergent utilization, and CAHPS to positively influence future trends. • Develops and implements strategies to reduce member access grievances with contracted providers. • Oversees the IHH program and ensures IHH program alignment with department requirements, provider education and oversight, and general management of the IHH program • 15-30% travel, mostly daytime, throughout Massachusetts. Job Qualifications REQUIRED EDUCATION: Bachelor's Degree in Health or Business related field or equivalent experience. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: • 5-7 years experience servicing individual and groups of physicians, hospitals, integrated delivery systems, and ancillary providers with Medicaid and/or Medicare products • 5+ years previous managed healthcare experience. • Previous experience with community agencies and providers. • Experience demonstrating working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicare or Medicaid lines of business, including but not limited to: fee-for service, value-based contracts, capitation and delegation models, and various forms of risk, ASO, agreements, etc. • Experience with preparing and presenting formal presentations. • 2+ years in a direct or matrix leadership position • Min. 2 years experience managing/supervising employees. PREFERRED EDUCATION: Master's Degree in Health or Business related field PREFERRED EXPERIENCE: • 5-7 years managed healthcare administration experience. • Specific experience in provider services, operations, and/or contract negotiations in a Medicare and Medicaid managed healthcare setting, ideally with different provider types (e.g., physician, groups and hospitals). 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.
    $44k-76k yearly est. Auto-Apply 15d ago
  • Associate Specialist, Appeals & Grievances

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    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.
    $32k-62k yearly est. Auto-Apply 7d ago
  • Senior Medical Records Collector

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    JOB DESCRIPTION Job SummaryProvides senior level support for medical records collection activities. Responsible for quality improvement activities including 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. • Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. • Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. • Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. • Provides mentorship and leadership to team members and represents at a senior level for process and project improvement initiatives. • Participates in and prepares feedback for meetings with vendors related to the medical record collection process. • Some medical records collection related travel may be required. Required Qualifications• At least 2 years of health care experience, including medical records support experience in a managed 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. • Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). • 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). 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
    $37k-41k yearly est. Auto-Apply 1d ago
  • Supervisor, Eligibility & Screening - Field travel in Dane County, WI

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    JOB DESCRIPTION Job SummaryLeads and supervises team supporting long-term care eligibility, screening processes and coordination for older adults and adults with physical or intellectual disabilities. Contributes to overarching strategy to provide quality and cost-effective care. Essential Job Duties • Hires, trains, develops and supervises eligibility screeners; responsible for hiring and training new eligibility screeners, check-ins with team members, feedback and coaching, and ongoing compliance and quality of eligibility screener work. • Assists in problem-solving and decision-making related to screens, member related issues, adverse eligibility findings, timing of screens, coordination of screens with moves and discharges, and other screening issues that arise. • Attends meetings and represents as subject matter expert and consultant to key stakeholders in regards to the long-term care functional screen (LTCFS) program, and attends and facilitate fair hearings related to functional ineligibility. • Completes the adult LTCFS as required and outlined in applicable regulatory guidelines; this includes completing collateral contacts to verify screen findings with internal and external stakeholders, and verifying diagnosis information with physicians and/or the Social Security Administration (SSA). • Complies with documentation and LTCFS program regulations, guidelines and meets screening quota. • Participates in and assists with screener meetings, quizzes and testing. • Collaborates on development, process improvement and ongoing quality management of services of related LTCFS materials/products. • Provides data reports related to the LTCFS as requested. • Maintains long-term functional screening LTCFS certification by completing and passing continuing skills testing (CST). • Local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 5 years of experience in health care, and at least 3 years experience managed long-term care and/or human services serving one of the target groups (adults with physical/intellectual disabilities or older adults), or equivalent combination of relevant education and experience., or equivalent combination of relevant education and experience. • Current long-term functional screening (LTCFS) certification. • Registered Nurse (RN) may be required for certain states (dependent upon state/contractual requirements). If licensed, license must be active and unrestricted. • Demonstrated understanding of electronic medical records and Health Insurance Portability and Accountability Act (HIPAA). • Strong organizational and time-management skills. • Ability to write routine reports, correspondence, and speak effectively with internal and external stakeholders. • Ability to regularly make decisions related to how a project or operation will be conducted. • Ability to read, analyze, and interpret business manuals, technical procedures, and government regulations. • Excellent verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Supervisory/leadership 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
    $51k-84k yearly est. Auto-Apply 1d ago
  • AOT Lab Phlebotomist

    HCA 4.5company rating

    Thousand Oaks, CA job

    Hourly Wage Estimate: 31.04 - 36.57 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. 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 an AOT Lab Phlebotomist today with Los Robles Regional Medical Center. Benefits Los Robles Regional Medical Center 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 an AOT Lab Phlebotomist. 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 This is an entry level position in the clinical laboratory which primarily consists of entering patient demographic information and laboratory test orders into the computer system, as well as other routine clerical tasks, such as faxing reports and answering phone inquiries. It may also involve specimen collection duties if required by the specific schedule assignment and if the individual assigned has a phlebotomy certificate and has demonstrated the requisite skills / competence. If that is you, come be a part of what makes us great and apply today! * Data entry for laboratory patient demographics and tests orders * Phone inquiry and facsimile responses to requests for laboratory service and reports * Photocopying, filing, collation, and charting of laboratory reports * Pre-analytical processing of specimens sent to laboratory for testing * Venipuncture, skin puncture for collection of patient specimens What qualifications you will need: * High School Graduate or Equivalent * (CPT) Certified Phlebotomy Technician Los Robles Regional Medical Center is a 380+ bed acute care hospital dedicated to serving the residents of Ventura and Los Angeles Counties along with the Greater Conejo Valley. We are the only Level II Trauma Center in East Ventura County. We are known for providing excellent care with compassion and kindness to each of our patients. In addition, Los Robles Regional Medical Center features a 24-hour emergency department, comprehensive stroke center, ICU/CCU, maternity, Level III NICU, comprehensive cancer center, heart & cardiovascular center, same day surgery, and rehab center. 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 cost 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 AOT Lab Phlebotomist 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.
    $48k-58k yearly est. 3d ago
  • Senior Analyst, IT Systems - AI Technical Project Manager - Mobile Apps

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Long Beach, CA

    Knowledge/Skills/Abilities •Mentors and leads 2-10 software engineers on multiple projects for project deliverables, assess deliverables' quality, plan and implement corrective and preventive actions to improve application quality. •Evaluates alternative systems solutions and recommends solution that best meets the need of the business. •Develops the BRDs along with business stakeholders, Conceptual Designs for multiple projects concurrently. SOX compliant Project deliveries and Project coordination. •Translates user requirements into overall functional architecture for complex s/w solutions in compliance with industry regulations. •Drives Joint Applications Development session with business stakeholders to define business requirements and provides systems/application expertise for multiple projects concurrently. •Communicates with cross functional teams (and if applicable, vended partners) to coordinate requirements, design and enhancements with the development team(s). •Assesses and analyzes computer system capabilities, work flow and scheduling limitations to determine if requested program or program change is possible within existing system. •Recognizes, identifies and documents potential areas where existing business processes require change, or where new processes need to be developed, and makes recommendations in these areas. •Works independently and resolves complex business problems with no supervision. •Mentors and leads 2-10 systems or programmer analysts on multiple projects for project deliverables, assesses deliverables' quality, plans and implements corrective and preventive actions to improve application quality. •Works with project managers to define work assignments for development team(s). •Identifies, defines and plans software engineering process improvements and verifies compliance. •Mentors and trains systems/programmer analysts on software applications, business domain and design standards. •Conducts peer review of other analysts (internal and contract staff) to ensure standards and quality. •Recommends, schedules and performs software systems/applications improvements and updates. •Conducts studies pertaining to designs of new information systems to meet current and projected needs. •Defines and plans software releases in accordance with other software applications. Assists in the project definition, execution and implementation. Provides application, business process or functional domain leadership/expertise and peer mentoring to IT staff. Provides expertise to one or multiple domain such as application development, business process re-engineering, enterprise integration, logical data modeling, project coordination, estimation, metrics generation, status reporting. Provides thought leadership or hands-on expertise for problem resolution, application enhancements, user training and documentation of business processes. Strong application delivery methodology or SDLC background, functional domain or software engineering expertise or proficiency. Manages small or medium size projects as assigned. •Excellent verbal and written communication skills •Must be knowledgeable of business processes, industry standard quality norms, systems and applications development best practices, project management methodologies and estimation processes. Job Qualifications Required Education Bachelor's Degree in Computer Science or related field or equivalent experience Required Experience 3-5 years experience supporting, designing and/or implementing application changes. Preferred Education Master's Degree Preferred Experience QNXT knowledge. SharePoint, MS Project experience. 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.
    $130k-165k yearly est. Auto-Apply 60d+ ago
  • RN Surgical First Assist

    HCA 4.5company rating

    Thousand Oaks, CA job

    Hourly Wage Estimate: 56.00 - 79.00 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Introduction Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: RN Surgical First Assist Los Robles Regional Medical Center Benefits Los Robles Regional Medical Center 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. We are seeking a(an) RN Surgical First Assist for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? 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! Job Summary and Qualifications Performs direct patient care through utilization of the nursing process in accordance with the California Nurse Practice Act, physician orders, hospital policies and procedures, and established professional standards. The RN is responsible and accountable for the delivery of safe, competent care either through direct delivery of that care or appropriate delegation and for performance improvement and quality initiatives as appropriate. * You will assess the health status of the patient in order to develop an individualized plan of care by collecting, categorizing, and interpreting data (physical and psychosocial) from documented information, observation, patient/family interview and other health care team members. * You will Instruct the patient and family to assist the patient in the achievement of optimal health status document nursing activities to provide a permanent record, for continuity of care, quality improvement and professional accountability. * You will Plan, supervise and assist with the transfer of the patient to protect the patient and personnel from injury. * You will Coordinate support services need during surgery by anticipating and communicating patient and surgical team needs * You will Provides assigned patients and families with explanation of procedures, treatments and medications * You will demonstrate organizational, time-management, and priority-setting skills. * You will ensure knowledge of hospital and department performance improvement initiatives and participates actively to contribute to improvement efforts. What qualifications you will need: * Valid California RN license. * Current BCLS Certification. * Current CRNFA Certification * Minimum of one-year experience in specialty preferred. * Graduate from an accredited school of nursing. Los Robles Regional Medical Center is a 380+ bed acute care hospital dedicated to serving the residents of Ventura and Los Angeles Counties along with the Greater Conejo Valley. We are the only Level II Trauma Center in East Ventura County. We are known for providing excellent care with compassion and kindness to each of our patients. In addition, Los Robles Regional Medical Center features a 24-hour emergency department, comprehensive stroke center, ICU/CCU, maternity, Level III NICU, comprehensive cancer center, heart & cardiovascular center, same day surgery, and rehab center. 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 cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you find this opportunity compelling, we encourage you to apply for our RN Surgical First Assist opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing - 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.
    $66k-81k yearly est. 60d+ ago

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