35 Healthcare Professionals jobs in Gresham
Senior Healthcare Recruiting Specialist
Posted 3 days ago
Job Viewed
Job Description
About Us
Welcome to a transformative experience in healthcare recruiting! At MLR, we're not just another staffing agency; we're a cutting-edge platform that brings together advanced technology with seasoned professionals to reshape how healthcare organizations find and hire the right talent. Built from a rich history of industry insight, our approach focuses on transparency, security, and performance, ensuring that we deliver exceptional results every time.
As a company dedicated to community and service, MLR is on a mission to empower healthcare organizations of all sizes, connecting them faster and more effectively with passionate individuals. Here, we understand that exceptional healthcare begins with extraordinary people - and that begins with you.
Your Role
Do you possess the innate ability to connect, close, and consult? Imagine if, instead of managing a desk, you could construct your personal brand while amplifying your impact - all backed by the resources and strategies of a Fortune 500 company. We are seeking dynamic recruiters to join our team as Senior Healthcare Recruiters . This position is far more than merely filling vacancies; it serves as a launchpad for your professional journey. Equipped with top-notch technology, marketing strategies, and operational support, you will be empowered to cultivate your brand while achieving remarkable results.
Your responsibilities will encompass full-cycle recruitment, nurturing resilient partnerships, and benefitting from some of the industry's highest commission rates that directly reflect your contributions.
Responsibilities
- Manage Complete Search Processes: You will oversee every aspect of the search, from intake to closure.
- Act as an Advisor: Gain a deep understanding of client hiring needs and their cultural nuances.
- Strategic Sourcing: Utilize our bespoke CRM/ATS alongside your network to source the best candidates.
- Utilize Our Platform: Efficiently manage candidates, track outreach, automate follow-ups, and maintain organization.
- Focus on Permanent Placements: Prioritize roles that foster long-lasting client relationships and lucrative commissions.
- Engage in Thought Leadership: Help elevate both our brand and your own within our industry.
We have crafted an environment where obstacles are minimized, enabling you to concentrate on what truly matters - forging connections and driving outcomes.
- Integrated Technology Access: Enjoy a robust all-in-one tech platform that combines CRM, ATS, and marketing communications - no more juggling multiple tools or managing chaos!
- Personalized Marketing Support: Want to grow your personal brand? We'll assist with creating captivating recruiter landing pages, campaigns, and promotional materials.
- Operational Support: We handle everything from contracts to compliance, freeing you to focus on recruitment.
- Incentive-Based Compensation: Attractive commission rates with no cap - your earnings reflect your success!
- Flexible Work Model: Fully remote with the freedom to work from anywhere - achieve a fulfilling work-life balance.
- At least 2-3 years of experience in agency recruiting or consultative sales.
- A solid grasp of the healthcare landscape, or a willingness to learn - we're here to support your growth!
- Proficient in nurturing client relationships and successfully closing offers.
- Comfortable navigating ATS/CRM systems (training provided).
- An entrepreneurial spirit with aspirations for long-term success.
At MLR, we prioritize empowerment over micromanagement, offering you the infrastructure to truly scale not just your placements but your personal recruiting enterprise. Whether your ambition is to earn 7-figure commissions, develop executive relationships, or create a specialized vertical with our support, we provide you with the tools to realize your goals.
This Role is Ideal For:
- Experienced recruiters looking to expand their horizons.
- Healthcare sales experts or industry insiders wanting a career transition.
- Recruiters from conventional agencies who seek freedom from administrative burdens and commission caps.
- Individuals focused on relationship building that emphasize earning based on impact over hours worked.
Join Us in Revolutionizing Healthcare Recruiting!
We are not just a typical staffing agency; we are a tech-enhanced recruiting platform that values our senior recruiters as strategic partners in our mission. Ready to work smart, earn more, and expand your influence in the healthcare sector? We invite you to connect with us.
Apply now, and start enhancing your brand with the support you deserve.
Healthcare Financial/Actuarial Director
Posted today
Job Viewed
Job Description
As a Health and Benefits Financial/Actuarial Director, you will serve as the financial lead for large, complex client assignments. You'll leverage your experience as a benefits financial/actuarial expert to make strategic recommendations on funding, plan design and innovative financial solutions. You will apply your financial management and data analytics expertise to solve complex client problems and to lead the development of new H&B intellectual capital.
+ Communicates and delivers complex concepts and financial/actuarial/analytic results to effectively drive client action and improve plan performance
+ Leads Medium to Large clients' financial/actuarial engagements
+ Develops and delivers the financial/actuarial strategy for a portfolio of Medium and/or Large clients
+ Drives revenue growth through client sales of additional actuarial, financial, and/or risk solutions
+ Provides consulting quality reviews and client delivery for all types of financial/actuarial deliverables
+ Guides team (regional and global) on deliverables based on client need; review models and presentations for client delivery
+ Builds relationships internally and collaborates effectively on cross-functional teams
**Qualifications**
+ 10+ years' experience and demonstrated success in the delivery of complex health and welfare financial/actuarial strategies and analysis in a consulting or brokerage environment
+ Proven ability to generate revenue
+ Track record of success in managing and growing client relationships
+ Deep understanding and expert knowledge in all aspects of employee benefit plan design, underwriting and funding concepts
+ Proven ability to lead data analytic projects
+ Interest and aptitude in keeping abreast of latest developments in health and welfare plan strategy and leading the development of new intellectual capital
+ Ability to leverage judgement and past experiences to predict which methods will work
+ Multiple years of experience across one or multiple client segments
+ An executive presence with polished and well developed written and oral communication skills
+ Superior ability to influence and collaborate with senior management and work across all levels of an organization
+ Excellent Microsoft Office skills, particularly in Excel and PowerPoint
+ State Life and Health license required within 90 days of joining
+ Actuarial designation and current continuing education (optional)
This position will remain posted for a minimum of three business days from the date posted or until a sufficient/appropriate candidate slate has been identified
Note: Employment-based non-immigrant visa sponsorship and/or assistance is not offered for this specific job opportunity.
**Compensation and Benefits**
Base salary range and benefits information for this position are being included in accordance with requirements of various state/local pay transparency legislation. Please note that salaries may vary for different individuals in the same role based on several factors, including but not limited to location of the role, individual competencies, education/professional certifications, qualifications/experience, performance in the role.
**Compensation**
The base salary compensation range being offered for this role is $140,000 -$200,000 USD per year.
This role is also eligible for an annual short-term incentive bonus.
**Company Benefits**
WTW provides a competitive benefit package which includes the following (eligibility requirements apply):
+ **Health and Welfare Benefits:** Medical (including prescription coverage), Dental, Vision, Health Savings Account, Commuter Account, Health Care and Dependent Care Flexible Spending Accounts, Group Accident, Group Critical Illness, Life Insurance, AD&D, Group Legal, Identify Theft Protection, Wellbeing Program and Work/Life Resources (including Employee Assistance Program)
+ **Leave Benefits:** Paid Holidays, Annual Paid Time Off (includes paid state/local paid leave where required), Short-Term Disability, Long-Term Disability, Other Leaves (e.g., Bereavement, FMLA, ADA, Jury Duty, Military Leave, and Parental and Adoption Leave), Paid Time Off ( ( _Washington State only_ )
+ **Retirement Benefits:** Contributory Pension Plan and Savings Plan (401k).
Pursuant to the San Francisco Fair Chance Ordinance and Los Angeles County Fair Chance Ordinance for Employers, we will consider for employment qualified applicants with arrest and conviction records.
At WTW, we trust you to know your work and the people, tools and environment you need to be successful. The majority of our colleagues work in a "hybrid" style, with a mix of remote, in-person and in-office interactions dependent on the needs of the team, role and clients. Our flexibility is rooted in trust and "hybrid" is not a one-size-fits-all solution.
We understand flexibility is key to supporting an inclusive and diverse workforce and so we encourage requests for all types of flexible working as well as location-based arrangements. Please speak to your recruiter to discuss more.
Marketing Manager - Healthcare Vertical

Posted 15 days ago
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Job Description
**Marketing Manager - Healthcare Vertical**
Remote-based position
Advance Local seeks a Marketing Manager to join our B2B marketing team as we continue to grow and innovate our Advance Healthcare Marketing agency brand throughout the United States.
The Marketing Manager will take a systematic approach to marketing strategy under the direction of the Director of Marketing Content. The ideal candidate will have a mixture of creative, analytical and leadership skills. You should be able to "feel" what is right while looking to data and numbers to guide the way.
In this role you will be strategic and fully versed in all aspects of campaign development and key success metrics; able to determine ROI metrics and analyze those results. Your work will be critical to developing B2B marketing strategy.
**You will:**
+ Strategize with Marketing Content Director to build all campaigns for one Healthcare Marketing brand. Manage content calendar, website posting, social media posts.
+ Creates or coordinates creation of content for whitepapers, posts and campaigns designing surveys, conducting research, and identifying subject matter experts for content creation.
+ Collaborate with Creative Director to order creative for all campaigns, collateral, Swag, booth materials, video, podcasts and more.
+ Collaboration with Marketing Operations Director to:
+ Design email sequences and coordinate lead generation forms for campaigns.
+ Report on lead generation attribution and marketing automation metrics.
+ Leverage data and CRM insights to identify customer segments, optimize campaign performance, and report on ROI to stakeholders.
+ Manage cross-functional projects, ensuring alignment with business objectives, brand standards, and timelines.
+ Collaborate with internal teams to ensure consistent brand messaging across digital, print, and in-person channels.
+ Contribute to a culture of innovation by bringing curiosity and examples of creative use of AI in professional marketing settings.
+ Experience shooting and editing basic social media video a plus.
**Our ideal candidate will have the following** :
+ Bachelor's degree in marketing, communications or related discipline required
+ Min 5 years' relevant marketing experience required with an emphasis on digital marketing
+ Experience managing and developing teams
+ Experience with Email marketing required
+ Knowledge of audience identification and engagement practices; ability to identify meaningful customer segments and evaluate the feasibility of marketing efforts to the segments
+ Experienced in using various media to effectively reach audiences (e.g., social media, mobile, email, search; ability to determine appropriate channels for the distribution of various products and services
+ Understanding of B2B digital strategies, products/services, product positioning and strengths/weaknesses
+ Be a creative thinker but also play a direct role in executing the details themselves
+ Exceptional writing, presentation, project management, leadership, organizational and communication skills
+ Strong people skills to work with all levels of management and across departments
+ Experience utilizing CRM software
This job requires reliable transportation to meet with co-workers or attend meetings/events.
**Additional Information**
Advance Local Media offers competitive pay and a comprehensive benefits package with affordable options for your healthcare including medical, dental and vision plans, mental health support options, flexible spending accounts, fertility assistance, a competitive 401(k) plan to help plan for your future, generous paid time off, paid parental and caregiver leave and an employee assistance program to support your work/life balance, optional legal assistance, life insurance options, as well as flexible holidays to honor cultural diversity.
Advance Local Media is one of the largest media groups in the United States, which operates the leading news and information companies in more than 20 cities, reaching 52+ million people monthly with our quality, real-time journalism and community engagement. Our company is built upon the values of Integrity, Customer-first, Inclusiveness, Collaboration and Forward-looking. For more information about Advance Local, please visit .
Advance Local Media includes MLive Media Group, Advance Ohio, Alabama Media Group, NJ Advance Media, Advance Media NY, MassLive Media, Oregonian Media Group, Staten Island Media Group, PA Media Group, ZeroSum, Headline Group, Adpearance, Advance Aviation, Advance Healthcare, Advance Education, Advance National Solutions, Advance Recruitment, Advance Travel & Tourism, BookingsCloud, Cloud Theory, Fox Dealer, Hoot Interactive, Red Clay Media, Search Optics, Subtext.
_Advance Local Media is proud to be an equal opportunity employer, encouraging applications from people of all backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, genetic information, national origin, age, disability, sexual orientation, marital status, veteran status, or any other category protected under federal, state or local law._
_If you need a reasonable accommodation because of a disability for any part of the employment process, please contact Human Resources and let us know the nature of your request and your contact information._
Advance Local Media does not provide sponsorship for work visas or employment authorization in the United States. Only candidates who are legally authorized to work in the U.S. will be considered for this position.
Manager, Workday Prism Lead - Healthcare
Posted 3 days ago
Job Viewed
Job Description
The KPMG Advisory practice is currently our fastest growing practice. We are seeing tremendous client demand, and looking forward we do not anticipate that slowing down. In this ever-changing market environment, our professionals must be adaptable and thrive in a collaborative, team-driven culture. At KPMG, our people are our number one priority. With a wealth of learning and career development opportunities, a world-class training facility and leading market tools, we make sure our people continue to grow both professionally and personally. If you're looking for a firm with a strong team connection where you can be your whole self, have an impact, advance your skills, deepen your experiences, and have the flexibility and access to constantly find new areas of inspiration and expand your capabilities, then consider a career in Advisory.
KPMG is currently seeking a Manager, Workday Prism in Enterprise Solutions for our Consulting practice.
Responsibilities :
- Participate in Workday projects involving strategy, implementation support, and Enterprise Resource Planning (ERP) optimization related to Information Technology (IT) operations, business processes, security, and data integrity for the Workday applications in Workday projects involving strategy, implementation support, and Workday optimization related to information technology operations, business processes, security, and data integrity for the applications
- Review and map Workday Integration and business processes
- Execute the day-to-day activities of Workday advisory engagements for a variety of clients including process design, package implementation lifecycle support, and project reviews
- Review business processes and advise clients on system services available within the Workday application
- Identify and communicate findings to senior management and client personnel
Qualifications :
- Minimum of five years of experience as a Workday Prism and Reporting Lead consultant with Workday implementation experience
- Minimum of five full life cycle implementations with Workday Prism, Workday Reporting, Advanced Reporting, Composite Reporting and BIRT as a Reporting Lead and Workday certification in Workday HCM, Financials or Integration (Please note that any candidate hired by KPMG into this position that doesn't currently hold the aforementioned certification will be required to secure one within three months from the commencement of employment)
- Bachelor's degree in an appropriate field from an accredited college/university
- Experience leading Reporting design, process alignment detailed understanding of ERP System concepts and general module functionality
- Detailed understanding of Workday Reporting processes and best practices
- Ability to travel as required
- Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. KPMG LLP will not sponsor applicants for U.S. work visa status for this opportunity (no sponsorship is available for H-1B, L-1, TN, O-1, E-3, H-1B1, F-1, J-1, OPT, CPT or any other employment-based visa)
KPMG LLP and its affiliates and subsidiaries ("KPMG") complies with all local/state regulations regarding displaying salary ranges. If required, the ranges displayed below or via the URL below are specifically for those potential hires who will work in the location(s) listed. Any offered salary is determined based on relevant factors such as applicant's skills, job responsibilities, prior relevant experience, certain degrees and certifications and market considerations. In addition, KPMG is proud to offer a comprehensive, competitive benefits package, with options designed to help you make the best decisions for yourself, your family, and your lifestyle. Available benefits are based on eligibility. Our Total Rewards package includes a variety of medical and dental plans, vision coverage, disability and life insurance, 401(k) plans, and a robust suite of personal well-being benefits to support your mental health. Depending on job classification, standard work hours, and years of service, KPMG provides Personal Time Off per fiscal year. Additionally, each year KPMG publishes a calendar of holidays to be observed during the year and provides eligible employees two breaks each year where employees will not be required to use Personal Time Off; one is at year end and the other is around the July 4th holiday. Additional details about our benefits can be found towards the bottom of our KPMG US Careers site at Benefits & How We Work.
Follow this link to obtain salary ranges by city outside of CA:
California Salary Range: $ - $
KPMG offers a comprehensive compensation and benefits package. KPMG is an equal opportunity employer. KPMG complies with all applicable federal, state and local laws regarding recruitment and hiring. All qualified applicants are considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, citizenship status, disability, protected veteran status, or any other category protected by applicable federal, state, or local laws. The attached link contains further information regarding KPMG's compliance with federal, state and local recruitment and hiring laws. No phone calls or agencies please.
KPMG recruits on a rolling basis. Candidates are considered as they apply, until the opportunity is filled. Candidates are encouraged to apply expeditiously to any role(s) for which they are qualified that is also of interest to them.
Los Angeles County applicants: Material job duties for this position are listed above. Criminal history may have a direct, adverse, and negative relationship with some of the material job duties of this position. These include the duties and responsibilities listed above, as well as the abilities to adhere to company policies, exercise sound judgment, effectively manage stress and work safely and respectfully with others, exhibit trustworthiness, and safeguard business operations and company reputation. Pursuant to the California Fair Chance Act, Los Angeles County Fair Chance Ordinance for Employers, Fair Chance Initiative for Hiring Ordinance, and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Sr. Associate, Workday Payroll - Healthcare
Posted 3 days ago
Job Viewed
Job Description
KPMG Advisory practice is currently our fastest growing practice. We are seeing tremendous client demand, and looking forward we do not anticipate that slowing down. In this ever-changing market environment, our professionals must be adaptable and thrive in a collaborative, team-driven culture. At KPMG, our people are our number one priority. With a wealth of learning and career development opportunities, a world-class training facility and leading market tools, we make sure our people continue to grow both professionally and personally. If you're looking for a firm with a strong team connection where you can be your whole self, have an impact, advance your skills, deepen your experiences, and have the flexibility and access to constantly find new areas of inspiration and expand your capabilities, then consider a career in Advisory.
KPMG is currently seeking a Sr. Associate, Workday HCM for our Consulting practice.
Responsibilities :
- Lead Workday Payroll Projects involving strategy, implementation support, and Enterprise Resource Planning optimization related to Information Technology operations, business process, security, data integrity for the Workday applications
- Support business development activities such as identification, proposal development, and other pursuit activities; work with the appropriate KPMG resources from other service lines/industries
- Lead day-to-day activities of ERP Advisory engagements for various clients, including process design, package implementation lifecycle support, and project reviews
- Supervise and performance manage staff working on assigned engagements
- Manage engagements according to KPMGs financial/cost management policies
Qualifications :
- Minimum of three years of recent enterprise resource planning, payroll implementation and upgrade experience with a completion of one full implementation with Workday Payroll; must be certified in Workday Payroll
- Bachelor's degree in an appropriate field from an accredited university/college
- Functional Payroll Certification (FPC) from American Payroll Association or equivalent from global payroll associations or prior demonstrated certification preferred
- Detailed understanding of enterprise resource planning system concepts and general module functionality
- Travel as needed
- Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. KPMG LLP will not sponsor applicants for U.S. work visa status for this opportunity (no sponsorship is available for H-1B, L-1, TN, O-1, E-3, H-1B1, F-1, J-1, OPT, CPT or any other employment-based visa)
KPMG LLP and its affiliates and subsidiaries ("KPMG") complies with all local/state regulations regarding displaying salary ranges. If required, the ranges displayed below or via the URL below are specifically for those potential hires who will work in the location(s) listed. Any offered salary is determined based on relevant factors such as applicant's skills, job responsibilities, prior relevant experience, certain degrees and certifications and market considerations. In addition, KPMG is proud to offer a comprehensive, competitive benefits package, with options designed to help you make the best decisions for yourself, your family, and your lifestyle. Available benefits are based on eligibility. Our Total Rewards package includes a variety of medical and dental plans, vision coverage, disability and life insurance, 401(k) plans, and a robust suite of personal well-being benefits to support your mental health. Depending on job classification, standard work hours, and years of service, KPMG provides Personal Time Off per fiscal year. Additionally, each year KPMG publishes a calendar of holidays to be observed during the year and provides eligible employees two breaks each year where employees will not be required to use Personal Time Off; one is at year end and the other is around the July 4th holiday. Additional details about our benefits can be found towards the bottom of our KPMG US Careers site at Benefits & How We Work.
Follow this link to obtain salary ranges by city outside of CA:
California Salary Range: $91000 - $
KPMG offers a comprehensive compensation and benefits package. KPMG is an equal opportunity employer. KPMG complies with all applicable federal, state and local laws regarding recruitment and hiring. All qualified applicants are considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, citizenship status, disability, protected veteran status, or any other category protected by applicable federal, state, or local laws. The attached link contains further information regarding KPMG's compliance with federal, state and local recruitment and hiring laws. No phone calls or agencies please.
KPMG recruits on a rolling basis. Candidates are considered as they apply, until the opportunity is filled. Candidates are encouraged to apply expeditiously to any role(s) for which they are qualified that is also of interest to them.
Los Angeles County applicants: Material job duties for this position are listed above. Criminal history may have a direct, adverse, and negative relationship with some of the material job duties of this position. These include the duties and responsibilities listed above, as well as the abilities to adhere to company policies, exercise sound judgment, effectively manage stress and work safely and respectfully with others, exhibit trustworthiness, and safeguard business operations and company reputation. Pursuant to the California Fair Chance Act, Los Angeles County Fair Chance Ordinance for Employers, Fair Chance Initiative for Hiring Ordinance, and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Healthcare Services Operations Support Auditor
Posted 1 day ago
Job Viewed
Job Description
Essential Job Duties
- Performs audits of non-clinical staff in utilization management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state and federal guidelines and requirements.
- Reports outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
- Ensures auditing approaches follow a Molina standard in approach and tool use.
- Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
- Demonstrates professionalism in all communications.
- Adheres to departmental standards, policies, protocols.
- Maintains detailed records of auditing results.
- Assists healthcare services with developing training materials or job aids as needed to address findings in audit results.
- Meets minimum production standards related to non-clinical auditing.
- May conduct staff trainings as needed.
- Communicates with quality, and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.
Required Qualifications
- At least 2 years health care experience, preferably in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
- Strong analytical and problem-solving skills.
- Ability to work in a cross-functional, professional environment.
- Ability to work on a team and independently.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
- Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non-clinical review/auditing experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $24 - $56.17 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Data Analyst (Healthcare Preferred) - Remote
Posted 8 days ago
Job Viewed
Job Description
Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Identifies and interprets trends and patterns in datasets to locate influences and provides recommendations and strategic/tactical plans based on findings. Collaborates within Care Connections and across departments to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates specifications for reports and analysis based on business needs and required or available data elements and works with Clinical Informatics to design. Creates solutions from initial concept to fully tested production products and communicates results to a broad range of audiences.
Effectively uses current and emerging technologies.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Extracts and compiles various sources of information and large data sets from various systems to identify and analyze data.
+ Sets up process for monitoring, tracking, and trending department data, including quality measures, effectiveness of communications, and process improvements.
+ Works with internal, external and enterprise stakeholders, as needed, to research, develop, and document new standard reports and/or processes.
+ Implements and uses the analytics software and systems to support department goals.
**JOB QUALIFICATIONS**
**Required Education**
Associate's Degree or equivalent combination of education and experience
**Required Experience**
1-3 years
**Preferred Education**
Bachelor's Degree or equivalent combination of education and experience
**Preferred Experience**
3-5 year
Quality and/or Medicare Stars knowledge highly preferred
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $116,835 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Healthcare Services Operations Support Auditor
Posted 10 days ago
Job Viewed
Job Description
Job Summary
Provides support for non-clinical healthcare services auditing activities. Responsible for performing audits for non-clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Performs audits of non-clinical staff in utilization management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state and federal guidelines and requirements.
- Reports outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
- Ensures auditing approaches follow a Molina standard in approach and tool use.
- Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
- Demonstrates professionalism in all communications.
- Adheres to departmental standards, policies, protocols.
- Maintains detailed records of auditing results.
- Assists healthcare services with developing training materials or job aids as needed to address findings in audit results.
- Meets minimum production standards related to non-clinical auditing.
- May conduct staff trainings as needed.
- Communicates with quality, and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.
Required Qualifications
- At least 2 years health care experience, preferably in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
- Strong analytical and problem-solving skills.
- Ability to work in a cross-functional, professional environment.
- Ability to work on a team and independently.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
- Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non-clinical review/auditing experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $24 - $56.17 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Senior Healthcare Economics Consultant - Remote

Posted 15 days ago
Job Viewed
Job Description
We are looking for a Senior Healthcare Economics Consultant to assist with the full analytics cycle, from gathering requirements and designing data models to building, maintaining, and enhancing dashboards. The ideal candidate will have the skills to take ownership of the entire process, ensuring data integrity, performance, and user satisfaction, while driving automation and process optimization.
If you are located in West Coast , you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Oversee the entire analytics cycle, including gathering business requirements, designing data models, creating dashboards, and ensuring their ongoing maintenance and enhancement
Collaborate with business partners, SMEs, and BAs to ensure alignment and clarity in requirements
Develop efficient, scalable ETL processes and manage the seamless ingestion of source data into the analytics platform
Create visually engaging, high-performance dashboards and reports that drive actionable insights
Provide ongoing support by answering user queries and making adjustments to existing reporting structures
Drive process improvements and optimization across the analytics development lifecycle
Communicate complex technical concepts to non-technical stakeholders effectively
Innovate by leveraging new technologies to enhance data analytics processes and meet emerging business needs
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ 2+ years of professional experience in data science, analytics, or a related field
+ Advanced SQL and experience
+ Experience with data visualization tools (e.g., Tableau, Power BI) to provide clear insights
+ Demonstrated ability to develop data models and automated processes
+ Demonstrated ability to transform raw data into meaningful insights that drive business performance
+ Willing or ability to work MDT or PDT hours
**Preferred Qualifications:**
+ Experience in the US Healthcare industry
+ Experience leading end-to-end analytics lifecycle and report development projects
+ Experience with managing large data sets within Snowflake
+ Experience working with or managing stakeholder relationships
+ Advanced Excel experience with exposure to Power Query
+ Exposure to analytics product or ETL automation and optimization
+ Demonstrated ability to understand user needs and deliver effective analytics solutions
+ Proven solid communication skills, both written and verbal
+ Proven solid organizational skills, attention to detail, and flexibility to changing business needs
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
Analyst, Healthcare Ops - Remote GA

Posted 16 days ago
Job Viewed
Job Description
***Candidate must reside in Georgia***
**Job Summary**
Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
Molina Healthcare Core Competencies: Generally, the ability to understand, internalize, exhibit and promote behaviors that reflect Molina Healthcare's Core Values.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Helps to oversee development, organization, and ongoing maintenance of data representing a wide range of healthcare information.
+ Identifies and completes report enhancements/fixes.
+ Assists with completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
+ Establishes and maintains timelines for reports and projects.
+ Generates and distributes weekly/monthly/quarterly/annually standard reports.
+ Must have experience in analyzing Utilization management, member health risk assessment data using SQL, Databricks and create reports using PowerBI
+ Must be able to collaborate with Executive teams in Utilization management, Operations, Core EIM teams.
**JOB QUALIFICATIONS**
**Required Education**
Associate degree or equivalent combination of education and experience
**Required Experience**
1-3 years
**Preferred Education**
Bachelor's Degree or equivalent combination of education and experience
**Preferred Experience**
3-5 years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
#PJHPO
Pay Range: $21.16 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.