24 Administration jobs in West Valley City
Recruitment Administration Specialist
Posted 5 days ago
Job Viewed
Job Description
Millions look to us to progress their careers. We look to you.
Global, culturally diverse, inclusive, and innovative - welcome to AMS, where talent is our world. Over the last two decades, AMS has redefined the landscape of talent outsourcing and consulting. From pioneering the concept of RPO to continually revolutionizing how organizations approach talent acquisition, AMS stands as a world leader in the industry.
Committed, engaged, and inspired, we feel a real sense of belonging, and all have one thing in common: a real passion for talent. Become part of this world and make a difference with us.
The Role
Would you like to be a vital part of a team dedicated to finding top talent? We would like to talk with you!
As a Recruitment Administration Specialist you'll play a crucial part in our Talent Acquisition process, ensuring smooth and efficient operations at every step. Your responsibilities will focus on managing candidate databases, coordinating communication and facilitating information for reporting purposes. You'll focus on maintaining candidate records, tracking progress, and providing administrative support to the recruitment team.
This is an FTC/remote or hybrid within Dallas or SLC.
Key Accountabilities
We will rely on you to:
- Managing account specific administration activities for the following scope of services: CV capturing, requisition management, help desk support, candidate checklist management, candidate care, offer management, updating applicant tracking system.
- Managing other various ad-hoc administration activities to support the effective running of the recruitment process e.g., updating Operations Manual or other process documentation
- Completing reports and trackers accurately and to deadlines
- Building and maintaining strong working relationships between all parties including recruiters, hiring managers, vendors and other account stakeholders
- Ensuring stakeholders and colleagues are continually appraised and updated on the relevant processes, including changes providing first line support for managing and resolving escalations
- Reviewing processes to identify areas of improvement
What you need to have to be successful:
- Experience in recruitment or recruitment administration
- Strong admin skills and experience
- Stakeholder management skills and experience
- Effective English business communication skills, written and oral
- Working knowledge of Microsoft packages; Outlook, Word, Excel
Other
Why AMS?
At AMS, we recognize the value of different perspectives and experiences in prompting innovation, sparking creativity, and solving problems.
We come from every walk of life, and our culture is open and inclusive. Our people enjoy flexibility, autonomy, and being trusted to work their way. We offer you career opportunities in every direction you want to explore. It's our world but you can do it your way.
We offer:
- Full training and support
- High value and challenging work
- A vibrant, diverse, and collaborative culture
- Flexible working
- A competitive reward and benefits package*
- The opportunity to embark on a recruitment career with one of the world's leading recruitment companies
Our culture of inclusion and belonging.
We welcome applications from people of all backgrounds, and all aspects of employment are based on merit, qualifications, and business needs. We do not discriminate based upon age, disability, gender identity, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, sexual orientation, or any other applicable legally protected characteristic.
If you require any accommodations or have any accessibility needs, please reach out via email or make a member of our Talent Acquisition team aware at any time.
Hit the Apply now button to get your journey started!
General Application - Staff/Administration
Posted 23 days ago
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Job Description
Job Type
Full-time, Part-time
Description
About Joyce University
At Joyce University, we're dedicated to nursing and health sciences. Prioritizing outcomes, our students progress faster. Emphasizing excellence, our graduates are empowered, passing professional exams at higher rates. Our programs are focused and rigorous, supported by a community of teachers, students, staff, and alumni committed to patient care and each other. This commitment is central to our shared success. Because together we are stronger, sharper, and more prepared - together, we are Joyce.
We look forward to welcoming you to our university community.
Why Join Joyce:
- Excellent Benefits
- Amazing Professional Development
- World-Class Education Assistance
- Generous Time Off Philosophy
- Spend Your Time Making a Difference
Our greatest benefit is our mission. Our people choose education because they want to make a difference. It's why we continue educating ourselves and our students because each graduate we inspire leaves Joyce ready to make the world better.
Requirements
Required Education:
High School Diploma or equivalency
EQUAL EMPLOYMENT OPPORTUNITY POLICY:
Joyce University provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Senior Installation Administration Professional
Posted 2 days ago
Job Viewed
Job Description
The Senior Installation Administration Professional establishes and manages relationships with internal and external clients. Coordinates end to end process from the point of sale to members loaded in system, ID cards issued, claims opened for processing and certifications issued. The Senior Installation Administration Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
**Job Description**
The Senior Installation Administration Professional creates accurate and timely reporting of implementation data, status, and metrics. Serves as the control point for all requirements gathering and dissemination of information to functional areas. Leads post-implementation stabilization process, if applicable. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Responsibilities**
· Overall accountability for the end-to-end implementation process from point of sale to go-live
· Capable of prioritizing and balancing multiple responsibilities and projects, pivoting where necessary
· Implement strategies to streamline processes with a focus on achieving measurable improvements in key performance indicators
· Facilitates innovative client solutions for unique group setup
**Use your skills to make an impact**
**Required Qualifications**
· Bachelor's degree or 3 years equivalent healthcare experience
· Previous relationship management experience
· Experience implementing, managing, or consulting on accounts from 10-100,000 lives/retirees
· Ability to effectively communicate with leadership and peers, inside and outside the organization, both verbal and written
· Project or process management experience
· Proficient with Microsoft suite to include proficiency with Excel (sort pivot tables, compare excel files systematically, etc.)
· Ability to utilize analytical thinking and determine root cause(s) and recommended solution(s) as well as identify trends for preventative action
· Analytical thinker with success in introducing new processes and/or process improvements in operational environments
**Preferred Qualifications:**
· Group Medicare knowledge
· Self-starter who takes initiative, ownership and anticipates future trends accurately
**Additional Information**
Travel 20-25%
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
+ Satellite, cellular and microwave connection can be used only if approved by leadership
+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
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.
$71,100 - $97,800 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.
Application Deadline: 07-18-2025
**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.
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**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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
Associate Dean & Director, Healthcare Administration
Posted today
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Job Description
If you're passionate about building a better future for individuals, communities, and our country-and you're committed to working hard to play your part in building that future-consider WGU as the next step in your career. Driven by a mission to expand access to higher education through online, competency-based degree programs, WGU is also committed to being a great place to work for a diverse workforce of student-focused professionals. The university has pioneered a new way to learn in the 21st century, one that has received praise from academic, industry, government, and media leaders. Whatever your role, working for WGU gives you a part to play in helping students graduate, creating a better tomorrow for themselves and their families. The salary range for this position takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. At WGU, it is not typical for an individual to be hired at or near the top of the range for their position, and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is: Grade: Management_Executive 610Pay Range: $122,100.00 - $19,800.00 Job Description Essential Functions and Responsibilities: P&L ownership experience with managing over INSERT + P&L with focus on achieving WGU contribution margins and net new student growth Program management and program marketing experience in launching new and revised programs into the education market and operating programs using data and insights; data-driven portfolio management experience Drive a culture of continuous experimentation, measurement, and learning from data to rapidly improve the quality and delivery to students Strong people leader to directly or indirectly lead a diverse team of INSERT + people including program managers, instructional faculty, and student coaches/mentors Influences Others and Communicates Effectively: Communicates to improve and promote teamwork, decision making, and problem solving. Listens and responds effectively to the reactions and positions of others and encourages the expression of diverse ideas and opinions. Adjusts message and style to fit the audience. Provides timely and helpful feedback. Communicates appropriately to win support with all audiences. Collaborates: Works cooperatively with others across the organization to achieve shared objectives. Represents own interests while being fair to others and their areas. Partners with others to get work done. Credits others for their contributions and accomplishments. Gains buy-in, trust and support of others. Manages Ambiguity: Deals comfortably with the uncertainty of change. Effectively handles risk. Can decide to act without the total picture. Is calm and productive, even when things are up in the air. Deals constructively with problems that do not have clear solutions or outcomes. Drives for Results: Has a strong outcomes-based orientation. Persists in accomplishing objectives despite obstacles and setbacks. Has a track record of successfully achieving goals. Pushes self and helps others achieve results. Has a continuous improvement mindset. Builds Effective Teams: Forms teams with appropriate and diverse mixes of styles, perspectives, and experience. Establishes common objectives and a shared mindset. Creates a feeling of belonging and strong team morale. Shares wins and rewards team efforts. Fosters open dialogue and collaboration among the team. Creates a team that works well cross-functionally. Organizational Learning: Learns quickly when facing new situations. Experiments to find new solutions. Takes on challenges of unfamiliar tasks. Extracts lessons-learned from failures and mistakes. Expands knowledge base through ongoing curiosity. Performs other related duties as assigned. Knowledge, Skill and Abilities: Deep understanding of how students learn and combining innovative curriculum and student support strategies to drive student success and employability Customer and student obsession with a focus on driving successful outcomes for them Industry or academic leader in the discipline Understanding of the industry trends, job opportunities, and educational market trends in the discipline Credible voice of the department in external partnerships and presentation opportunities Strong people leader to directly or indirectly lead a diverse team of INSERT + people including academic program leaders, instructional faculty, and student coaches/mentors Execution focus with the ability to dive-deep and live in the details with a fast-paced weekly execution cadence Ability to organize and coordinate activities and results across cross-functional teams Ability to coach and develop direct reports Ability to collaborate with and manage teams, including those in a remote environment, while demonstrating excellence, integrity, and respect Ability to work effectively in a highly matrixed organization Ability to build relationships and influence at all levels, both internally and externally Ability to be an agent of change in a rapidly changing environment Proven ability to analyze data to identify trends and drive innovation Sound judgement and decision-making skills Strong oral and written communication skills Job Qualifications: Minimum Qualifications: Master's degree in relevant area from an accredited institution Five (5) years in a similar design and product ownership role, demonstrating expertise in marketing, continuous improvement, and thought leadership. Demonstrated ability to lead cross-functional teams and scale initiatives . Preferred Qualifications: Terminal degree in a relevant field from an accredited institution. Experience in higher education, particularly in online education programs or in rapidly evolving organizations/programs. Expertise in developing curriculum and/or high-stakes assessments. Proven success in leading change management efforts and bringing structure to complex, dynamic situations Physical Requirements: Prolonged periods sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. #LI-TM1 Position & Application Details Full-Time Regular Positions (classified as regular and working 40 standard weekly hours): This is a full-time, regular position (classified for 40 standard weekly hours) that is eligible for bonuses; medical, dental, vision, telehealth and mental healthcare; health savings account and flexible spending account; basic and voluntary life insurance; disability coverage; accident, critical illness and hospital indemnity supplemental coverages; legal and identity theft coverage; retirement savings plan; wellbeing program; discounted WGU tuition; and flexible paid time off for rest and relaxation with no need for accrual, flexible paid sick time with no need for accrual, 11 paid holidays, and other paid leaves, including up to 12 weeks of parental leave. How to Apply: If interested, an application will need to be submitted online. Internal WGU employees will need to apply through the internal job board in Workday. Additional Information Disclaimer: The job posting highlights the most critical responsibilities and requirements of the job. It's not all-inclusive. Accommodations: Applicants with disabilities who require assistance or accommodation during the application or interview process should contact our Talent Acquisition team at Equal Employment Opportunity: All qualified applicants will receive consideration for employment without regard to any protected characteristic as required by law. #J-18808-Ljbffr
Senior Specialist, Provider Network Administration
Posted today
Job Viewed
Job Description
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Generates and prepares provider-related data and reports in support of Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry Research & Resolution, Provider Contracting/Provider Relationship Management).
+ Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations. Report examples may include: GeoAccess Availability Reports, Provider Online Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports.
+ Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree or equivalent combination of education and experience
**Required Experience**
+ 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration.
+ 3+ years' experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 5+ years managed care experience
+ QNXT; SQL experience
+ Crystal Reports for data extraction
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: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Senior Specialist, Provider Network Administration
Posted today
Job Viewed
Job Description
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Generates and prepares provider-related data and reports in support of Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry Research & Resolution, Provider Contracting/Provider Relationship Management).
+ Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations. Report examples may include: GeoAccess Availability Reports, Provider Online Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports.
+ Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree or equivalent combination of education and experience
**Required Experience**
+ 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration.
+ 3+ years' experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 5+ years managed care experience
+ QNXT; SQL experience
+ Crystal Reports for data extraction
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: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Sr. Manager, Medicaid Contract Administration
Posted 8 days ago
Job Viewed
Job Description
**Job Overview**
We are currently seeking a dynamic, highly motivated, and experienced individual for the position of Sr. Manager, Medicaid Contract Administration. This position is responsible for managing the Medicaid rebate team in receiving, processing, validating, trouble-shooting Medicaid claims and dispute resolution with state agencies. This position requires a detailed understanding of the life science industry specific to the Medicaid payer landscape. The decisions made in this position affect company sales, pricing discounts, and best price implications. This role also facilitates working relationships with both internal and external customers.
**Job Duties & Responsibilities**
+ Lead operations person for all Medicaid decisions as it relates to Model N implementation and payment process.
+ Experience in processing Medicaid rebates preferably using Model N software application or other similar industry standard software.
+ Investigate, analyze information, and resolve business questions by applying information from various data sources, business rules and system processes.
+ Ability to understand and perform complex rebate and best price calculations.
+ Able to foster and maintain constructive working relationships with customers while resolving business issues dealing with data correctness.
+ Interact with internal departments (Internal Audit, Commercial Insights, Contracting, SOX Compliance, and Legal) to clarify policy compliance requirements and contract language clauses.
+ Keep current on regulatory and industry changes that may impact Medicaid operations.
+ Oversee the Medicaid Dispute Resolution process.
+ Keen attention to detail and ability to conduct repetitive transactions and processes using computer systems.
+ Identifies and resolves discrepancies in submitted data invoices to ensure legitimacy of contract discounts.
+ Ensures detailed accuracy of correct data input into company systems.
+ Maintains service standards in processing data submitted by customers and proactively advises management of issues.
+ Able to identify and recommend improvements in business procedures and outcomes.
+ Create and maintain ongoing SOP documentation for department processes and confirm adherence to final policies and system requirements.
+ Train staff on Medicaid landscape and Model N system navigation.
+ Manage a staff with a concentration on career development.
+ Performs other responsibilities as assigned.
**Key Core Competencies**
+ Six plus years' experience in the healthcare/pharmaceutical industry.
+ Knowledge and experience in common industry software programs (i.e., Model N).
+ Has experience in processing Medicaid rebates preferably using Model N software application or other similar industry standard software.
+ Able to investigate, analyze information, and resolve business questions by applying information from various data sources, business rules and system processes.
+ Proficient in MS Office (Word, Excel, Access, PowerPoint, MS Project, Visio, SharePoint).
+ Customer-focused ability to communicate across all levels of the organization.
+ Excellent written skills required.
+ Strong problem solving, critical thinking, communication, and sound judgment skills.
+ Solid experience in supporting System/application jobs and troubleshooting production issues in complex software solutions.
+ Fast paced environment handling multiple demands.
+ Must be able to exercise appropriate judgment as necessary.
+ Requires a high level of initiative and independence.
+ Strong attention to detail required.
+ High degree of organizational awareness, ability to connect the dots to understand all the interdependency and big picture.
**Education & Experience**
+ Minimum 8 - 12 (w/o Master's) or 6 - 8 years (with Master's) years of relevant experience in biotech or pharmaceutical industry.
The base salary range for this role is $153,920 to $192,400. Base salary is part of our total rewards package which also includes the opportunity for merit-based salary increases, short incentive plan participation, eligibility for our 401(k) plan, medical, dental, vision, life and disability insurances and leaves provided in line with your work state. Our robust time-off policy includes flexible paid time off, 11 paid holidays plus additional time off for a shut-down period during the last week of December, 80 hours of paid sick time upon hire and each year thereafter. Total compensation, including base salary to be offered, will depend on elements unique to each candidate, including candidate experience, skills, education and other factors permitted by law.
Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.
**Confidential Data** : All information (written, verbal, electronic, etc.) that an employee encounters is considered confidential.
**Compliance** : Achieve and maintain Compliance with all applicable regulatory, legal and operational rules and procedures, by ensuring that all plans and activities for and on behalf of Sumitomo Pharma America (SMPA) and affiliates are carried out with the "best" industry practices and the highest ethical standards.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
**Mental/Physical Requirements** : Fast paced environment handling multiple demands. Must be able to exercise appropriate judgment as necessary. Requires a high level of initiative and independence. Excellent written and oral communication skills required. Requires ability to use a personal computer for extended periods of time.
**Sumitomo Pharma America (SMPA)** **is an Equal Employment Opportunity (EEO) employer**
Qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law.
Sumitomo Pharma Co., Ltd. is a global pharmaceutical company based in Japan with key operations in the U.S. (Sumitomo Pharma America, Inc.), Canada (Sumitomo Pharma Canada, Inc.) and Europe (Sumitomo Pharma Switzerland GmbH) focused on addressing patient needs in oncology, urology, women's health, rare diseases, psychiatry & neurology, and cell & gene therapies. With several marketed products in the U.S., Canada, and Europe, a diverse pipeline of early- to late-stage assets, and in-house advanced technology capabilities, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website ( or follow us on LinkedIn ( .
At Sumitomo Pharma America, our work is guided by the Sumitomo Pharma mission, vision and values, which tie closely to our company's cultural pillars.
**Our** **Mission**
_To broadly contribute to society through value creation based on innovative research and development activities for the betterment of healthcare and fuller lives of people_ _worldwide_
**Our** **Vision**
_For Longer and Healthier Lives, we unlock the future with cutting edge technology and_ _ideas_
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Specialist, Provider Network Administration - Remote
Posted 10 days ago
Job Viewed
Job Description
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Oversees receipt of and coordinates data from the provider network for entry into the plan's provider management system.
+ Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided.
+ Audits loaded provider records for quality and financial accuracy and provides documented feedback.
+ Assists in configuration issues with Corporate team members.
+ Assists in training current staff and new hires as necessary.
+ Conducts or participates in special projects as requested.
**JOB QUALIFICATIONS**
**Required Education**
Associate degree in Business or equivalent combination of education and experience
**Required Experience**
+ Min. 3 years managed care experience
+ Experience in one or more of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
+ Claims processing background including coordination of benefits, subrogation, and/or eligibility criteria.
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 3+ years Provider Claims and/or Provider Network Administration experience
+ Experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
+ Credentialing Knowledge
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: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Specialist, Provider Network Administration - Remote
Posted 10 days ago
Job Viewed
Job Description
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Oversees receipt of and coordinates data from the provider network for entry into the plan's provider management system.
+ Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided.
+ Audits loaded provider records for quality and financial accuracy and provides documented feedback.
+ Assists in configuration issues with Corporate team members.
+ Assists in training current staff and new hires as necessary.
+ Conducts or participates in special projects as requested.
**JOB QUALIFICATIONS**
**Required Education**
Associate degree in Business or equivalent combination of education and experience
**Required Experience**
+ Min. 3 years managed care experience
+ Experience in one or more of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
+ Claims processing background including coordination of benefits, subrogation, and/or eligibility criteria.
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 3+ years Provider Claims and/or Provider Network Administration experience
+ Experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
+ Credentialing Knowledge
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: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Director, Medicare Administration (Regulatory SME) - REMOTE
Posted 4 days ago
Job Viewed
Job Description
**Job Summary**
Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and services.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Establishes audit controls and measurements to ensure correct processes are established. Develops and performs internal audits/risk assessments, monitoring program for Molina Healthcare departments. Provides post audit findings and recommendations to ensure contractual State and Federal Compliance.
+ Coordinates development of written policies and procedures regarding compliance with local, state and federal guidelines.
+ Establishes member grievance appeals and policies and updates annually or as directed by the Centers for Medicare and Medicaid Services.
+ Establishes non-contracted provider dispute and appeals policies and policies and updates annually or as directed by the Center for Medicare and Medicaid.
+ Responsible for development, implementation, and maintenance of department strategic initiatives.
**JOB QUALIFICATIONS**
**Required Education**
Graduate Degree or equivalent combination of education and experience
**Required Experience**
7-9 years
**Preferred Experience**
10+ 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: $88,453 - $172,981 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.