Operations Manager jobs at Molina Healthcare - 30 jobs

+ Provides customer support and stellar service to meet the needs of our Molina members and providers. + Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. + Provides product and service information and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Supervises a team of employees. Trains, coaches, monitors, and manages the team's performance to meet or exceed company and department performance expectations. + Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. + Ensures compliance with Contractual and Regulatory requirements. + Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal responsibility and accountability and leads by example through individual performance. + Support projects and special initiatives as appropriate. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** + 3-5 years' experience in a call center environment + 1-2 years supervisory experience **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 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: $45,390 - $84,086 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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 Manager, Field Reimbursement Services is responsible for leading a team of field-based reimbursement managers and day to day operations of a field reimbursement program sourced to McKesson by a pharmaceutical manufacturer client. The primary objective for the Manager, Field Reimbursement role is to hire, develop, coach, evaluate, culture-build and lead the reimbursement team, allowing them to successfully engage specialty physician offices and support the manufacturer customer. Additional responsibilities include the overall management of program operations including, but not limited to, staffing, profitability, standard operating procedures, process design, process implementation and process improvements. The position will monitor client SLA agreements to ensure compliance, making staffing and process changes if SLA is not being met. The supervisory guidance includes a nation-wide team of remote-based direct reports requiring monitoring activity, performance development and extensive travel for in-person training and ride-a-longs. Finally, this role will regularly interact with members throughout the Client's organization, primarily with the Client's head of Reimbursement Operations, while also acting as a liaison within McKesson representing the field-based reimbursement team to Client Services, Information Systems, Business Analyst's, Quality Assurance and Training to achieve synergy of processes, training, efficiency and ultimately, customer satisfaction. Key Responsibilities: Leadership of a team of field-based reimbursement specialists who are responsible for providing in-office reimbursement and patient support services in an assigned territory. Responsible for all administrative, training and performance management duties associated with team leadership. This includes weekly 1:1 meeting with FRMs, weekly FRM team meetings, and conducting monthly check - ins, quarterly performance surveys, and monthly QA audits of FRM activity. The field-based reimbursement team is an extension of the McKesson-operated reimbursement and patient-support services operated on behalf of the Client. The role is responsible for the effective communication and partnership between the field team and their home office counterparts. This includes establishing weekly meetings with client and operations team to ensure consistency in expectations and two - way communication. Disseminating client direction across remote team, leadership of regular team teleconferences and quarterly ride-a-longs with individual team members for on-going training and development. Responsible for providing Field Operations efficiencies and overall innovative ideas to enhance Field Reimbursement Program as a whole. Not only provide ideas but also execute on Field Operation projects. Manager is responsible for completing and execution of projects assigned. Ensuring that all SLA and other contractual commitments are met. Responsible for team's adherence to all applicable privacy and compliance obligations. SLAs and adherence are established in the Rules of Engagement document and vary by client. Activity is measured in FRM SFDC to ensure adherence and SLA expectations are met. Works in tandem with Client's Head of Reimbursement Operations ensuring the execution of Client's strategic initiatives. Managerial oversight of day-to-day team activities and reporting of results to McKesson Client Services and key Client Contacts. Manager will partner with the Sr. Manager to establish and produce the reports that the Client will receive each month and quarter. Manages client expectations regarding delivery of services and provides customer with proactive consultative services on process improvement, revenue generating & cost saving opportunities. These can be evaluated based on FRM SFDC reporting, operations reporting, and client satisfaction each quarter. Assists in preparation of and participates in Quarterly Business Reviews to the client on the state of their business and outlines opportunities for enhancement, growth, efficiency, etc. Manager is responsible for FRM Development. Manager partner with FRM to establish a minimum of two development opportunities to assist in career path. In addition, the manager will provide ongoing training and educational opportunities that compliment Field Reimbursement role. This can include but not limited to payer education, conferences, mentorships, billing and coding and My Learning courses selected by Manager. Minimum Job Qualifications (Knowledge, Skills & Abilities) 6+ years of reimbursement experience and 2+ years of supervisory experience 4-year degree in related field or equivalent experience Critical Requirements: Experience supporting a Field Reimbursement Team preferred Experience managing a field-based team, with management of a field-based reimbursement team strongly preferred. Proven account management/client management experience, preferably in a pharmacy or healthcare related industry. Proven experience in direct communication with pharmaceutical clients or stakeholders. Specialized Knowledge/Skills: Collaborative, customer focused, and able to create visible value to client and within the organization. Ability to develop strong team relationships and bring individuals together to focus on team goals. Proven ability to handle multiple projects toward effective solutions and according to budget and timelines Detailed understanding and experience with process documentation and improvement. Experience with Microsoft Office Suite Excellent verbal and written communication skills Working Conditions: General Office Demands - Remote, WFH Travel Requirements Must be able to travel 60-80% (3-4 days a week) via automobile or plane. Must have a valid driver's license with a clean driving record/ MVR. Physical Requirements: Possible long periods of sitting and/or keyboard work. 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 $79,500 - $132,500 McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind: McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application. McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates. McKesson job postings are posted on our career site: careers.mckesson.com. McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!

Become a part of our caring community and help us put health first The Associate Director, Database Administration manages and maintains all production and non-production databases. Responsible for standards and design of physical data storage, maintenance, access and security administration. The Associate Director, Database Administration requires a solid understanding of how organization capabilities interrelate across department(s). The Associate Director will lead the design, reliability, scalability, and operational excellence of Humana's enterprise data platforms across multi cloud and on-prem environments. This role is responsible for ensuring high availability, performance, security, compliance, and cost efficiency for mission-critical data systems supporting analytics, AI/ML, and customer-facing applications. This leader will partner closely with Application, Data Engineering, Analytics, Product, Security, Finance, and Platform Engineering teams to define and operate standardized, resilient, and automated database platforms across technologies such as SQL Server, Oracle, PostgreSQL, MongoDB, Snowflake, Databricks, and other modern data services. In addition, this role will spearhead the application of AI and Generative AI to database operations and data platform reliability-driving predictive insights, automated remediation, intelligent observability, and operational copilots that reduce manual overhead while maintaining strict healthcare compliance (HIPAA, PHI). Key Responsibilities: Data Platform Strategy & Operations Leadership Define and execute the enterprise database and data platform operations strategy across cloud and on-prem environments. Provide senior-level guidance on platform standards, architectural decisions, lifecycle management, and modernization of relational and non-relational databases. Establish short-, mid-, and long-term roadmaps for data platform reliability, scalability, automation, and cost optimization. Lead the operational maturity model for data platforms, aligned with SRE and platform engineering best practices. Reliability, Availability & SRE for Data Platforms Own 24/7 availability and performance of mission-critical database and analytics platforms. Lead escalated incident, problem, and root cause analysis for data platform outages, performance degradation, and data integrity issues (24/7/365). Define and improve MTTD / MTTR through proactive monitoring, automation, and AI-assisted diagnostics. Establish SLOs, SLIs, and error budgets for database and analytics platforms. Database Operations & Managed Services Lead and govern Managed Service Providers (MSPs) supporting database operations across cloud and on-prem environments. Build and maintain L2/L3 SOPs for database operations, backup/recovery, patching, failover, and disaster recovery. Oversee change planning, release coordination, and operational readiness for database platform upgrades and migrations. Support and guide cloud and on-prem database migrations, including legacy modernization initiatives. Observability, Monitoring & Automation Establish enterprise-grade observability for data platforms, including metrics, logs, traces, query performance, and capacity forecasting. Partner with observability teams to implement event correlation, anomaly detection, and intelligent alerting for databases and data pipelines. Identify manual operational tasks and drive automation through scripting, APIs, and platform tooling. Partner with DevOps and Platform Engineering on CI/CD for database changes, schema management, and infrastructure-as-code. AI & GenAI for Database and Data Platform Operations Lead research, prototyping, and adoption of AI/GenAI to enhance database and data platform operations. Design AI-driven capabilities for: Predictive capacity and performance forecasting Automated incident detection and triage Query and workload optimization recommendations Intelligent root cause analysis and log summarization Develop AI copilots and natural-language tools to support database engineers and operations teams. Integrate LLMs and ML models into observability platforms for real-time insights and self-healing actions. Security, Compliance & Governance Ensure database platforms adhere to security best practices, regulatory requirements, and healthcare compliance standards (HIPAA, PHI). Partner with Security and Risk teams to continuously assess vulnerabilities, access controls, encryption, and audit readiness. Define governance standards for data access, retention, backup, and recovery across platforms. Cost Optimization & FinOps for Data Platforms Lead cost transparency, optimization, and forecasting for cloud and on-prem database platforms. Implement chargeback/showback models for database and analytics consumption. Partner with Finance and stakeholders to optimize storage, compute, licensing, and usage patterns. Analyze usage, utilization, and growth trends to reduce total cost of ownership. Reporting, Metrics & Continuous Improvement Define and publish operational dashboards and executive-level reporting for data platform health, cost, and performance. Analyze operational data to identify trends, risks, and improvement opportunities. Drive standardization and platform consistency across teams to improve efficiency and reliability. Act as a trusted advisor on data platform capabilities, limitations, and best practices. AI / GenAI & Advanced Capabilities Experience or strong interest in AI/ML or GenAI applications for operational intelligence. Familiarity with LLMs, vector databases, predictive analytics, or AI-driven monitoring solutions. Ability to move rapidly from concept → pilot → production for AI-enabled operational enhancements. Use your skills to make an impact Required Qualifications: Bachelor's Degree 10+ years of experience in database, data platform, or infrastructure engineering/operations, with 5+ years in a senior leadership role. Deep hands-on experience with enterprise database and analytics platforms, such as: SQL Server, PostgreSQL, MySQL MongoDB or other NoSQL platforms Snowflake, Databricks, or similar analytics platforms Strong understanding of SRE, ITIL/ITSM, and operational best practices for data platforms. Proven experience operating 24/7, high-availability, mission-critical systems. Experience applying automation and infrastructure-as-code (Terraform, Ansible, scripting). Advanced understanding of observability for data platforms (performance, capacity, query analysis). Strong analytical, reporting, and stakeholder communication skills. Experience integrating new technologies with existing technologies Experience implementing technologies with enterprise-wide impact Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Familiarity with Agile methodologies Healthcare industry experience Cloud certifications (Azure, AWS, GCP) and/or database platform certifications Experience with CI/CD pipelines for database and analytics platforms ITIL, SRE, or Platform Engineering certifications Additional Information Work-At-Home Requirements WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information #LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $142,300 - $195,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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 Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences. The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met. FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues. Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience. Position will require travel, project management and/or account coordination based on client expectation. Key Responsibilities: Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regard to Reimbursement challenges and support services that are available. Office interaction will include education and reimbursement support. On-site/virtual interactions will average 15 per week. These activities are recorded in FRM CRM daily with reporting to manager weekly. Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams. Monthly activity reporting captures educational topics at FRM level reportable to client based on client expectation. This trended data is also reported quarterly to client. Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs. FRM will collaborate with case manager on average of 4/month and ad hoc as needed for escalations. These interactions are tracked in FRM CRM and hub system. Responsible for setting up appointments and completing outbound calls to targeted offices. Assist in completing backlog casework. Additional day-to-day in-office work. Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information. All FRM interactions/activities are tracked in FRM CRM which are reportable to management and client. Monitor program performance for physicians and manufacturer representatives in accordance with expectations. Territory performance will be monitored via FRM CRM dashboard daily. Trending results will be identified through quarterly reporting. Additionally, clients have the option to survey customers on program performance. Research and compile provider / manufacturer representative specific information for reimbursement database. (Includes account profiles) FRM will create a facility database on each new provider in FRM CRM. All interactions/activities are built utilizing this database. Minimum Job Qualifications - 4-year degree in related field or equivalent experience 4+ years of healthcare related reimbursement experience Business Experience - Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy. Experience supporting oncology products preferred Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician's office or clinics. Must have Medicare and commercial insurance coverage experience. Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis. Proven presentation skills and experience Proven ability to effectively handle multiple priorities and excellent organizational skills Strong Computer literacy to include PowerPoint and Web Meeting experience Specialized Knowledge/Skills - Previous field experience, a plus Previous experience with specialty pharmacy a plus Account management experience, a plus Excellent Interpersonal skills. Excellent written and oral communication skills Problem solving and decision-making skills Working Conditions: General Office Demands - Remote, WFH Travel Requirements Must reside in territory - Tulsa, OK or Little Rock, AR Must be able to travel 80% (4 days a week) via automobile or plane Must have a valid driver's license with a clean driving record/ MVR Physical Requirements (Lifting, standing, etc.) - Possible long periods of sitting and/or keyboard work. General office demands. 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 $72,200 - $120,400 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!

is incentive eligible. **Job Summary and Qualifications** The Regional Coding Operations Manager (RCOM) is responsible for assisting in the development and evolution of the overall strategy for Physician Services Group (PSG) Coding Operations. The RCOM is responsible for oversight of all PSG coding operational processes and workflow, including but not limited to, practice acquisitions, provider clinical documentation improvement, practice coding processes, and division relationship management as applicable. The RCOM assists the Regional Coding Operations Director with the oversight and implementation of Coding Operations operational planning, service commitment, budgets, workflow processes and internal controls. As the RCOM, this person serves as a key promoter of Coding Operations and is responsible for setting the tone of Coding Operations as a service organization, continuously seeking to understand, meet, and exceed customer expectations and needs. ***This position is considered Work from Home and will support our practices in the Fort Lauderdale and Miami markets. This leader **must be based in the Miami, Fort Lauderdale or surrounding areas** or be willing to relocate to the area in order to support our practices across the division. *** Job Summary and Qualifications + Provides coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business case expectations and operational metrics to ensure that financial and operational risks are properly managed. + Works with the division operations team and CCU team on practice implementation/acquisition activities and projects. + Leads key communication efforts with practice staff, providers, and Division Leadership. + Provides direction and guidance to the practice management and Division Leadership teams to ensure accurate and efficient coding processes. + PSG Coding Operations works with Central Coding Unit (CCU) to identify and resolve issues. + Works collaboratively with each practice and division leadership team to ensure customer satisfaction and efficient coding work processes. + Assists the coding process in serving as a liaison between the CCU team and practice management, including the providers and division leadership while building and maintaining strategic working relationships with the practice and division leadership (working through specific issues, committee meetings, monthly updates, etc.). + Assumes a lead role for innovation, knowledge sharing and leading best practice identification. + Manages coding education for practice management and practice/division staff. + Contributes to the development of strategic direction for Coding Operations. + Practices and adheres to the "Code of Conduct" philosophy and "Mission and Value Statement". + Must be willing to be present within physician practices daily to include minimal overnight travel. EDUCATION: + Bachelor's Degree preferred. + Must be a Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator) through AHIMA (American Health Information Management Association) or AAPC's (American Academy of Professional Coders) Certified Professional Coder (CPC ) credential or Certified Professional Coder - Hospital (CPC-H ) or Certified Risk Adjustment Coder (CRC) EXPERIENCE: + Experience with Cerner and eClinicalWorks (eCW) is strongly preferred. + Minimum 7 years professional fee coding and revenue cycle operations experience strongly preferred. + Minimum 5 years health care management/leadership experience required. + Experience leading large organizations preferred. **Benefits** HCA Healthcare 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) Regional Coding Operations Manager WFH 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! Physician Services Group (*********************************************************** is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare's graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of 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 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 Regional Coding Operations Manager WFH 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.

is incentive eligible. **Job Summary and Qualifications** The Regional Coding Operations Manager (RCOM) is responsible for assisting in the development and evolution of the overall strategy for Physician Services Group (PSG) Coding Operations. The RCOM is responsible for oversight of all PSG coding operational processes and workflow, including but not limited to, practice acquisitions, provider clinical documentation improvement, practice coding processes, and division relationship management as applicable. The RCOM assists the Regional Coding Operations Director with the oversight and implementation of Coding Operations operational planning, service commitment, budgets, workflow processes and internal controls. As the RCOM, this person serves as a key promoter of Coding Operations and is responsible for setting the tone of Coding Operations as a service organization, continuously seeking to understand, meet, and exceed customer expectations and needs. ***This position is considered Work from Home and will support our practices in the Fort Lauderdale and Miami markets. This leader **must be based in the Miami, Fort Lauderdale or surrounding areas** or be willing to relocate to the area in order to support our practices across the division. *** Job Summary and Qualifications + Provides coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business case expectations and operational metrics to ensure that financial and operational risks are properly managed. + Works with the division operations team and CCU team on practice implementation/acquisition activities and projects. + Leads key communication efforts with practice staff, providers, and Division Leadership. + Provides direction and guidance to the practice management and Division Leadership teams to ensure accurate and efficient coding processes. + PSG Coding Operations works with Central Coding Unit (CCU) to identify and resolve issues. + Works collaboratively with each practice and division leadership team to ensure customer satisfaction and efficient coding work processes. + Assists the coding process in serving as a liaison between the CCU team and practice management, including the providers and division leadership while building and maintaining strategic working relationships with the practice and division leadership (working through specific issues, committee meetings, monthly updates, etc.). + Assumes a lead role for innovation, knowledge sharing and leading best practice identification. + Manages coding education for practice management and practice/division staff. + Contributes to the development of strategic direction for Coding Operations. + Practices and adheres to the "Code of Conduct" philosophy and "Mission and Value Statement". + Must be willing to be present within physician practices daily to include minimal overnight travel. EDUCATION: + Bachelor's Degree preferred. + Must be a Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator) through AHIMA (American Health Information Management Association) or AAPC's (American Academy of Professional Coders) Certified Professional Coder (CPC ) credential or Certified Professional Coder - Hospital (CPC-H ) or Certified Risk Adjustment Coder (CRC) EXPERIENCE: + Experience with Cerner and eClinicalWorks (eCW) is strongly preferred. + Minimum 7 years professional fee coding and revenue cycle operations experience strongly preferred. + Minimum 5 years health care management/leadership experience required. + Experience leading large organizations preferred. **Benefits** HCA Healthcare 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) Regional Coding Operations Manager WFH 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! Physician Services Group (*********************************************************** is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare's graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of 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 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 Regional Coding Operations Manager WFH 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.

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. Strategic Account Operations Manager (Pharma) Reporting to the Sr. Manager of Account Operations, the Strategic Account Operations Manager provides oversight and management of assigned complex and strategic accounts, ensuring the customer and program activity is appropriately managed throughout the customer lifecycle, understanding the programs may evolve frequently. This individual will drive outstanding customer experience, program and contract accuracy, and cross business unit collaboration and consistency. He/She must be able to work effectively with individuals in both business and technical roles. He/She should have ability to manage contractual obligations of customer and navigate across the various functions of the business. The Strategic Account Operations Manager is also responsible for balancing customer management with strategic projects benefitting the team, business and/or product. What Strategic Account Operations Managers Do? Primary responsibilities include: Serves as primary point of contact for day-to-day oversight and management of multiple, complex and strategic accounts, and ensures account satisfaction and engagement in support of account retention Accountable for the successful management of all account contract deliverables within contract terms and review of account invoices against contractual obligations for accuracy and validation Serves as initial point of contact for day-to-day program support and issues, researches and communicates corrective actions to resolve increasingly complex account problems directly, escalates concerns effectively when appropriate, and/or engages internal teams to assist as needed Documents and maintains program plans, measures progress towards account goals and objectives, and manages risk/mitigation plans Drives a culture of continuous improvement and operational excellence by leading process improvement initiatives and promoting best practices within the team to ensure a consistent, high quality and repeatable account experience Proactively utilizes data, working with internal and/or account data teams, to anticipate and evaluate trends/risks and make appropriate recommendations for accounts Proactively applies industry, customer experience management, and program optimization knowledge, engaging with internal/external stakeholders, to improve customer satisfaction and provide recommendations based on business needs and program goals Maintains strong, collaborative working relationships across CMM and McKesson, works with internal teams to assist in meeting account requirements, and leads activities among supporting teams Acts as a resource for colleagues with less experience and serves as an advisor on smaller account activities including issue resolution Participates in and/or leads special initiatives strategic to overall business and/or product line Critical Skills: Proven problem-solving skills Ability to build trust and credibility across all levels Composure and diplomacy under pressure when resolving urgent customer issues Strategic and creative thinker with confidence in sharing ideas Skilled at prioritizing multiple deliverables in cross-functional environments Strong project and process management expertise Experience in strategic customer relationship and experience management Proficient in contract/SLA oversight, risk mitigation, and solution optimization Effective task delegation and team coordination Strong data acumen Working knowledge of Salesforce (SFDC) preferred About You You love working with people - both colleagues and clients - in a fast-paced environment. You have a healthy mix of left-brain (detail-oriented and analytical) and right-brain (charismatic and collaborative). You take a data-driven approach to understanding your clients and are always up-to-date on industry trends. You are results-oriented, self-motivated, and have a high level of initiative. Bachelor's degree or equivalent 7+ years of customer support/account operations/account management experience and healthcare experience (prior experience in account management leadership a plus) Great communicator, either one-on-one, in writing, and in formal presentations, with clinical, operational, IT, and executive clients Ready to have an immediate impact on multiple client relationships Top-notch strategic acumen, problem-solving, and analytical ability Specialized Knowledge/Skills - Healthcare, Prior Authorization, Affordability (eV, DC, CoC, etc.) Biopharma knowledge a plus. Proven skills in project management. History working with customers and cross functional teams. 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 $97,800 - $163,000 McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind: McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application. McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates. McKesson job postings are posted on our career site: careers.mckesson.com. McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Applicants must reside in the state of Nebraska Experience with data analysis tied to utilization in a clinical setting is highly preferred. Position Purpose: Oversees the development and implementation of clinical initiatives and/or programs to improve care coordination, efficiency, and health and quality outcomes. Oversees the clinical operations team and works with senior leadership to ensure all clinical processes are consistent with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements. Oversees the development and review of clinical initiatives and/or programs to improve care coordination, efficiency, and health and quality outcomes Oversees clinical, quality, documentation, and data submission projects to achieve strategic objectives Reviews data analyses related to utilization, outcomes, safety, and costs to determine trends and identify areas of improvement for clinical initiatives and/or programs Develops, implements, and oversees clinical plans, policies, and procedures needed for strategic initiatives, programs, and improve processes and/or health and quality outcomes based on collected data Provides guidance and insight based on experience to clinical operations team on clinical processes and initiatives to improve care coordination, efficiency, and health and quality outcomes Identifies process improvements for clinical initiatives and/or programs and presents them to senior leadership team Manages and tracks achievements against goals and objectives for clinical operations team to improve care coordination, efficiency, and health and quality outcomes Works with senior leadership team to ensure clinical initiatives and/or programs are in accordance with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements Manages and coordinates the training of clinical operations team members to ensure adequate training and implementation of clinical initiatives and/or programs to improve care coordination, efficiency, and health and quality outcomes Supports in developing the overall strategy for onboarding, hiring, and training clinical operations team members Works cross functionally to drive process improvements to manage costs and support initiatives to improve health and quality outcomes Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires a Bachelor's degree and 6+ years of related experience, including prior management experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.Pay Range: $121,500.00 - $224,900.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

+ Provides customer support and stellar service to meet the needs of our Molina members and providers. + Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. + Provides product and service information and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Supervises a team of employees. Trains, coaches, monitors, and manages the team's performance to meet or exceed company and department performance expectations. + Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. + Ensures compliance with Contractual and Regulatory requirements. + Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal responsibility and accountability and leads by example through individual performance. + Support projects and special initiatives as appropriate. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** + 3-5 years' experience in a call center environment + 1-2 years supervisory experience **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 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: $45,390 - $84,086 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

+ Provides customer support and stellar service to meet the needs of our Molina members and providers. + Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. + Provides product and service information and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Supervises a team of employees. Trains, coaches, monitors, and manages the team's performance to meet or exceed company and department performance expectations. + Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. + Ensures compliance with Contractual and Regulatory requirements. + Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal responsibility and accountability and leads by example through individual performance. + Support projects and special initiatives as appropriate. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** + 3-5 years' experience in a call center environment + 1-2 years supervisory experience **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 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: $45,390 - $84,086 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

+ Provides customer support and stellar service to meet the needs of our Molina members and providers. + Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. + Provides product and service information and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Supervises a team of employees. Trains, coaches, monitors, and manages the team's performance to meet or exceed company and department performance expectations. + Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. + Ensures compliance with Contractual and Regulatory requirements. + Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal responsibility and accountability and leads by example through individual performance. + Support projects and special initiatives as appropriate. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** + 3-5 years' experience in a call center environment + 1-2 years supervisory experience **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 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: $45,390 - $84,086 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

+ Provides customer support and stellar service to meet the needs of our Molina members and providers. + Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. + Provides product and service information and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Supervises a team of employees. Trains, coaches, monitors, and manages the team's performance to meet or exceed company and department performance expectations. + Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. + Ensures compliance with Contractual and Regulatory requirements. + Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal responsibility and accountability and leads by example through individual performance. + Support projects and special initiatives as appropriate. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** + 3-5 years' experience in a call center environment + 1-2 years supervisory experience **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 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: $45,390 - $84,086 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

+ Provides customer support and stellar service to meet the needs of our Molina members and providers. + Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. + Provides product and service information and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Supervises a team of employees. Trains, coaches, monitors, and manages the team's performance to meet or exceed company and department performance expectations. + Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. + Ensures compliance with Contractual and Regulatory requirements. + Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal responsibility and accountability and leads by example through individual performance. + Support projects and special initiatives as appropriate. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** + 3-5 years' experience in a call center environment + 1-2 years supervisory experience **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 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: $45,390 - $84,086 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

+ Provides customer support and stellar service to meet the needs of our Molina members and providers. + Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. + Provides product and service information and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Supervises a team of employees. Trains, coaches, monitors, and manages the team's performance to meet or exceed company and department performance expectations. + Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. + Ensures compliance with Contractual and Regulatory requirements. + Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal responsibility and accountability and leads by example through individual performance. + Support projects and special initiatives as appropriate. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** + 3-5 years' experience in a call center environment + 1-2 years supervisory experience **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 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: $45,390 - $84,086 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

+ Provides customer support and stellar service to meet the needs of our Molina members and providers. + Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. + Provides product and service information and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Supervises a team of employees. Trains, coaches, monitors, and manages the team's performance to meet or exceed company and department performance expectations. + Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. + Ensures compliance with Contractual and Regulatory requirements. + Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal responsibility and accountability and leads by example through individual performance. + Support projects and special initiatives as appropriate. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** + 3-5 years' experience in a call center environment + 1-2 years supervisory experience **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 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: $45,390 - $84,086 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. In partnership with the CMO, serve as a key stakeholder, decision maker, and catalyst, for all market level population health identification, strategy, evaluation, and monitoring to achieve the Quadruple Aim and drive Centene's Population Health mission at the market level. Provide strategic leadership for population health internally, as well as with providers, community organizations, advocacy groups, and applicable legislature. Understand the local healthcare landscape to look for key drivers & opportunities for innovative models targeting the Quadruple Aim. Understand the unique community health needs and the attributes of the populations served to drive development of programs and service. Uses analytics to identify key insights about the populations served and drive the development of the interventions to target unique populations. Oversees performance of all UM functions (prior authorization, concurrent review) for the market per the defined partnership agreement; co-leads agenda planning and annual performance goal setting, unique to market needs Orchestrates all elements of the population health strategy for the business Drives MLR initiatives locally through strong partnership and routine with Finance Partner with the Special Investigations Unit (SIU) to proactively identify patterns of potential fraud, waste, and abuse (FWA) through clinical, claims, and utilization data insights, ensuring timely escalation and coordinated mitigation strategies. Additionally, NHHF will integrate SIU‑driven findings into Population Health & UM operational workflows, informing policy updates, provider education, and process improvements to prevent recurrence of FWA and enhance overall compliance and accountability. Partners with MDs to translate the needs of the members into intentional clinical program design that delivers successful health outcomes Liaises with state regulators for clinical programs; proactively reviews and evaluates the utility, performance and ROI of clinical programs and acts as lead/champion to drive awareness and advocacy where needed Develops comprehensive position papers-supported by clear rationale, data analysis, and documented recommendations-to advocate for program enhancements and strategic changes with internal and external stakeholders. Coordinates quality initiatives (audits, star ratings, contract reviews, etc.) and activate enterprise and local policies Informs and executes against contracts (including provider contracts) - driving outcomes captured in contract and operationalizing locally Contributing member of enterprise and local committees Serves as an integral member of the executive leadership team, charged with delivering clinical solutions to evolving business needs Executes on standards and customizing per local requirements while partnering with the COEs to drive continuous improvement through governance and performance monitoring. Education/Experience: Bachelor's Degree with 5+ years of relevant experience required. Master's Degree preferred. Current state RN license preferred. research, health policy, information technology or other relevant field. Must have at least five years of progressively responsible professional experience in population health, service coordination, ambulatory care, community health, case or care management, or coordinating care across multiple settings and with multiple providers. Proven leadership in a large, matrixed organization with 3-5 years of experience working with state or federal regulators Pay Range: $171,900.00 - $326,900.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. This is a unique executive leadership opportunity for a hands-on operator with enterprise vision. This role serves as the Chief Executive Officer of the Illinois Health Practice Alliance (IHPA) - a Behavioral Health Independent Practice Association and joint venture between Centene Corporation and Provider Co, and is responsible for day-to-day and long-term strategic leadership related to the performance of IHPA's statewide clinically integrated network. While titled at the VP level, this role carries full CEO accountability for a focused, high-impact organization.The role provides strategic, operational, and financial leadership to ensure IHPA's objectives align with broader business priorities while advancing value-based care, provider performance, and improved health outcomes for a diverse member population.Position Purpose: Plan and direct all aspects of the company's operational policies, objectives, and initiatives. Oversee the development of policies and procedures for operational processes to ensure optimization and compliance with established standards and regulations. Oversee the negotiation and administration of value based contracts to ensure a strong provider network. Influence and drive network provider performance. Ensure IHPA clients access to quality of care and adherence to regulatory requirements. Represent the organization in its relationships with all stakeholders, including health care providers, government agencies, trade associations, health plans, and similar groups. Deliver leadership and oversight to IHPA staff and contracted vendors. Develop a sound short-and long-range plan for the organization. Ensure the adequacy and soundness of the organization's financial structure and review projections of working capital requirements. Promote enrollment growth by supporting marketing event planning and execution. Develop and manage network provider relationships. Education/Experience: Bachelor's Degree in Business Administration, Finance, Accountancy or a related field required. Master's Degree preferred. 9+ years of operations, management, or administration in the healthcare or insurance industry required. Extensive experience in contracting, contract acquisition, operations management, and strategic planning and development. IPA experience preferred. Experience in an integrated delivery system and value-based contracting preferred. Understands the healthcare field from the provider and health plan perspectives, preferably in multiple states and knowledge of the Illinois market. Pay Range: $168,500.00 - $320,500.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. Leads the strategy and execution of technology solutions to support clinical operations, including but not limited to systems requirement gathering, monitoring and improvements. Oversees the implementation, integration, and ongoing support of clinical systems, as well as ensuring that technology effectively enables clinical staff to deliver high-quality care. Oversees and executes vision and roadmap in collaboration with clinical and technology leaders to drive enterprise-wide clinical technology initiatives and improvements. Partners with senior leaders to ensure successful product launch, execution, and support for technology solutions. Leads complex projects and technical innovation activities in collaboration with cross functional leaders in a matrixed environment. Leads the SME team who provides consultation and direct testing services for all technology initiatives and implementations. Partners with stakeholders to analyze system needs for all business operations functions, assist with system requirements, influences the design of integrated solutions, and develops integration strategies. Implements integration solutions within the operations space, ensure thorough testing to guarantee functionality and performance, and oversees deployment. Identifies and resolves issues related to system integration and provide technical support to end-users. Documents integration processes, workflows, and system configurations, and provides training to relevant personnel. Continuously monitors the performance of integrated systems, identifies areas for improvement, and optimizes system performance and reliability. In essence, the Operations and Systems Integration role is crucial for ensuring that different systems within an organization work together efficiently and effectively, supporting overall business objectives. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's Degree required or equivalent experience required 7+ years Strong understanding of system architecture, integration technologies, and relevant programming languages required 6+ years Ability to analyze complex technical issues, troubleshoot problems, and develop effective solutions required. Excellent verbal and written communication skills to effectively collaborate with teams, stakeholders, and end-users required. Ability to manage integration projects, prioritize tasks, and meet deadlines required Adaptability to changing technologies and business needs required or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Pay Range: $223,200.00 - $422,900.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. The Vice President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies that drive measurable improvements in member health. Reporting directly to the Chief Medical Officer, this leader will oversee a team of Directors and large cross-functional teams to ensure initiatives are strategically aligned, operationally executed, and continuously improved. This role is charged with assuring that the organization has a robust population health strategy that supports achievement of business goals, improves the current and future health of members, and aligns with the direction of Centene and the Ohio Department of Medicaid. While the primary focus is on Medicaid, the VP will also collaborate with organizational partners who lead Medicare and Marketplace initiatives to ensure alignment and shared best practices. Key Responsibilities Strategic Leadership Develop, implement, and maintain a comprehensive population health strategy that advances business objectives, improves member health outcomes, and aligns with Centene and the Ohio Department of Medicaid. Lead population health initiatives with a strong focus on Medicaid while collaborating with partners on Medicare and Marketplace programs. Translate organizational vision into actionable initiatives with clear metrics and accountability. Serve as a trusted advisor on population health strategy as part of the senior leadership team. Operational Execution Ensure the successful implementation of population health initiatives by driving accountability for results, measuring impact, and aligning resources with strategic priorities. Translate strategy into operational reality by building systems, processes, and performance standards that deliver sustained improvements in quality, outcomes, and efficiency. Integrate population health initiatives across clinical, operational, and financial functions to ensure consistency, compliance, and alignment with organizational goals. Continuously monitor program performance, identifying opportunities for innovation and course correction to achieve optimal results for members and the organization. Regulatory & Corporate Collaboration Build and maintain strong partnerships with the state Medicaid regulator to ensure compliance and program success. Collaborate with Centene corporate teams to align local initiatives with enterprise-wide strategies. Partner with leaders responsible for Medicare and Marketplace to ensure consistency, integration, and shared learning. Work closely with operations, finance, and other internal teams to achieve organizational objectives. Communication & Stakeholder Engagement Build trusted relationships with state regulators, providers, community partners, and internal executives to advance shared goals and improve member outcomes. Serve as a visible ambassador for population health initiatives, clearly articulating strategy, progress, and outcomes to diverse audiences, including the Board, senior leadership, regulators, and community stakeholders. Anticipate stakeholder needs and concerns, proactively engaging in dialogue that fosters collaboration, transparency, and alignment across all levels of the organization. Vendor & Partner Management Oversee relationships with key vendors to ensure programmatic success, accountability, and value. Negotiate and manage vendor contracts to align deliverables with organizational priorities. Team Leadership & Development Mentor, coach, and develop a high-performing team of Directors and staff. Delegate effectively while ensuring accountability and ownership across teams. Foster a culture of innovation, collaboration, and continuous improvement. Education/Experience: Current state RN license preferred. Previous experience in a managed care organization strongly preferred. 3+ years of leadership experience required. Master's degree or other advanced degree in nursing, social work, health services research, health policy, information technology or other relevant field. Must have at least five years of progressively responsible professional experience in population health, service coordination, ambulatory care, community health, case or care management, or coordinating care across multiple settings and with multiple providers. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Candidate must reside or relocate to Ohio Pay Range: $180,400.00 - $343,300.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act