12 Healthcare Professionals jobs in Post Falls
Healthcare Delivery Driver
83854 Post Falls, Idaho
Medical Couriers
Posted 3 days ago
Job Viewed
Job Description
Join Our Team as a Medical Courier!
We are currently hiring a Medical Courier to help us deliver essential medical supplies and equipment. Enjoy competitive pay ranging from $17 to $20 per hour, along with flexible working hours and optional hybrid vehicles for our drivers.
Your Responsibilities:
- Safely transport medical equipment, supplies, and specimens to various healthcare facilities.
- Ensure timely pick-up and delivery of time-sensitive packages.
- Maintain accurate records and handle all items with care.
- Communicate effectively with clients to confirm delivery specifics and manage any concerns.
- Adhere to all traffic laws and safety regulations while driving.
- Complete any required paperwork and documentation for each delivery.
What We Offer:
- Immediate hiring for qualified candidates.
- A supportive work environment with an emphasis on team collaboration.
- Opportunities for advancement within the healthcare delivery sector.
Join us and make a difference in the healthcare community!
View Now
0
Healthcare Services Operations Support Auditor
99207 Spokane, Washington
Molina Healthcare
Posted 1 day ago
Job Viewed
Job Description
JOB DESCRIPTION Job SummaryProvides 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.
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.
View Now
1
Data Analyst (Healthcare Preferred) - Remote
99207 Spokane, Washington
Molina Healthcare
Posted 8 days ago
Job Viewed
Job Description
**Job Summary**
Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. 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.
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.
View Now
2
Healthcare Services Operations Support Auditor
99207 Spokane, Washington
Molina Healthcare
Posted 10 days ago
Job Viewed
Job Description
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.
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.
View Now
3
Analyst, Healthcare Ops - Remote GA
99207 Spokane, Washington
Molina Healthcare
Posted 15 days ago
Job Viewed
Job Description
**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.
***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.
View Now
4
Senior Healthcare Recruitment Executive - Growth Path
99254 Spokane, Washington
MLee Healthcare Staffing and Recruiting, Inc
Posted 3 days ago
Job Viewed
Job Description
Join a Transformative Team as a Senior Healthcare Recruiter - Amplify Your Personal Brand with Comprehensive Support
A New Era in Healthcare Recruitment Awaits
At MLR, we take pride in being a forward-thinking healthcare staffing and recruitment operation, leveraging two decades of industry trust and expertise. With our foundations firmly planted in a commitment to innovation, we unite practical recruitment strategies with cutting-edge technology. Here, we do not just fill roles; we create lasting impacts in healthcare through a unique blend of automation and hands-on crafting.
Recognizing the challenges and lessons learned throughout the years, MLR was established with a vision to enhance transparency, security, and operational performance in the recruiting sphere. Our mission is to bridge the gap between healthcare organizations and qualified talent, ensuring that the right individuals are matched with the right positions swiftly and effectively. Through our robust platform, we infuse technology with humanity, cultivating an enriched community spirit.
We hold a fundamental belief: exceptional healthcare begins with exceptional people. It is our goal to find the right talent to contribute to this mission.
Position Overview
Are you a natural connector, equipped with the intuition of a consultant and the drive of a closer? Imagine elevating your recruiting experience, building a powerful brand, and harnessing the infrastructure of a Fortune 500 company while doing so!
We are on the lookout for seasoned, enterprising recruiters to join our dynamic team as Senior Medical Sales & Healthcare Recruiters . Your desk will evolve into a launchpad for your aspirations. Together, we will construct a platform that enhances your capabilities, arming top recruiters like you with the technology, marketing strategies, and operational frameworks to maximize your success and amplify your personal brand.
Your expertise will guide you through complete recruitment cycles, cultivating strong partnerships with clients. And, with our industry-leading commission structures, your hard work will not go unnoticed - you will reap the rewards proportionate to the value you deliver.
Core Responsibilities
We prioritize streamlining your workflow so you can focus on what you do best: connecting talent with opportunity.
We champion a philosophy centered around empowerment rather than micromanagement. Our strategic framework is designed to help you scale up - not just your placements, but your overall recruitment practice. Whether your aspiration involves achieving 7-figure commissions, establishing high-level client collaborations, or launching your unique vertical under our brand, we rendezvous with the right tools.
Who Fits This Role
Join Us in Redefining Recruitment
We're not just another agency; we're a platform for tech-enabled recruitment - one that treats seasoned recruiters as strategic partners rather than transactional entities. If you're thrilled by the idea of working smarter, earning more, and expanding your influence across the healthcare landscape, we'd love to connect!
Apply today and begin your journey of building a brand supported by the resources you truly deserve.
A New Era in Healthcare Recruitment Awaits
At MLR, we take pride in being a forward-thinking healthcare staffing and recruitment operation, leveraging two decades of industry trust and expertise. With our foundations firmly planted in a commitment to innovation, we unite practical recruitment strategies with cutting-edge technology. Here, we do not just fill roles; we create lasting impacts in healthcare through a unique blend of automation and hands-on crafting.
Recognizing the challenges and lessons learned throughout the years, MLR was established with a vision to enhance transparency, security, and operational performance in the recruiting sphere. Our mission is to bridge the gap between healthcare organizations and qualified talent, ensuring that the right individuals are matched with the right positions swiftly and effectively. Through our robust platform, we infuse technology with humanity, cultivating an enriched community spirit.
We hold a fundamental belief: exceptional healthcare begins with exceptional people. It is our goal to find the right talent to contribute to this mission.
Position Overview
Are you a natural connector, equipped with the intuition of a consultant and the drive of a closer? Imagine elevating your recruiting experience, building a powerful brand, and harnessing the infrastructure of a Fortune 500 company while doing so!
We are on the lookout for seasoned, enterprising recruiters to join our dynamic team as Senior Medical Sales & Healthcare Recruiters . Your desk will evolve into a launchpad for your aspirations. Together, we will construct a platform that enhances your capabilities, arming top recruiters like you with the technology, marketing strategies, and operational frameworks to maximize your success and amplify your personal brand.
Your expertise will guide you through complete recruitment cycles, cultivating strong partnerships with clients. And, with our industry-leading commission structures, your hard work will not go unnoticed - you will reap the rewards proportionate to the value you deliver.
Core Responsibilities
- Oversee Full-Cycle Recruitment, from initial intake to final offer.
- Act as a Dedicated Client Partner, gaining insights into their staffing needs, challenges, and company culture.
- Sourcing Talent Strategically using our proprietary tools alongside your existing network.
- Utilize Our Comprehensive Platform to manage candidate relationships, track outreach, automate communications, and maintain organization.
- Focus on Permanent Placements, generating lasting value for clients and substantial commissions for yourself.
- Engage in Thought Leadership initiatives to elevate our branding - and yours.
We prioritize streamlining your workflow so you can focus on what you do best: connecting talent with opportunity.
- Seamless Access to Our Integrated Tech Platform: Enjoy a comprehensive suite combining CRM, ATS, and marketing tools, all in a single interface. Say goodbye to managing multiple platforms and messy inboxes!
- Personal Brand Development Support: Seeking to expand your influence? We'll assist you in crafting personalized landing pages and marketing campaigns.
- Robust Recruiting Operations Support: From managing contracts to ensuring compliance and assisting with credentialing, we've got you covered.
- Uncapped Performance-Based Compensation: Benefit from high commission structures that far surpass industry standards.
- Fully Remote Flexibility: Work from wherever you love, with a schedule that suits your lifestyle.
- 2-3+ years of experience in agency recruiting or consultative sales.
- A solid understanding of the healthcare field or a willingness to learn - we provide the coaching!
- Skilled at managing client relationships and adept at closing offers.
- Confident in utilizing ATS/CRM systems (training on our system will be provided).
- An entrepreneurial spirit with a passion for developing something significant.
We champion a philosophy centered around empowerment rather than micromanagement. Our strategic framework is designed to help you scale up - not just your placements, but your overall recruitment practice. Whether your aspiration involves achieving 7-figure commissions, establishing high-level client collaborations, or launching your unique vertical under our brand, we rendezvous with the right tools.
Who Fits This Role
- Experienced recruiters keen to elevate their capabilities
- Healthcare professionals or sales experts looking for career shifts
- Agency recruiters seeking relief from administrative burdens and limited commissions
- Relationship-focused individuals eager to enjoy rewards based on impact rather than time spent
Join Us in Redefining Recruitment
We're not just another agency; we're a platform for tech-enabled recruitment - one that treats seasoned recruiters as strategic partners rather than transactional entities. If you're thrilled by the idea of working smarter, earning more, and expanding your influence across the healthcare landscape, we'd love to connect!
Apply today and begin your journey of building a brand supported by the resources you truly deserve.
View Now
5
Program Manager-Healthcare Enrollment Data (Remote)
99207 Spokane, Washington
Molina Healthcare
Posted 9 days ago
Job Viewed
Job Description
**JOB DESCRIPTION**
**Job Summary**
Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/program management.
**Job Duties**
+ Active collaborator with people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.
+ Plans and directs schedules as well as project budgets.
+ Monitors the project from inception through delivery.
+ May engage and oversee the work of external vendors.
+ Focuses on process improvement, organizational change management, program management and other processes relative to the business.
+ Leads and manages team in planning and executing business programs.
+ Serves as the subject matter expert in the functional area and leads programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. Delivers the appropriate artifacts as needed.
+ Works with operational leaders within the business to provide recommendations on opportunities for process improvements.
+ Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
+ Generate and distribute standard reports on schedule
+ SQL Experience
+ Root Cause Analysis
**JOB QUALIFICATIONS**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent combination of education and experience.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
+ 3-5 years of Program and/or Project management experience.
+ Operational Process Improvement experience.
+ Healthcare experience.
+ Experience with Microsoft Project and Visio.
+ Excellent presentation and communication skills.
+ Experience partnering with different levels of leadership across the organization.
**PREFERRED EDUCATION** :
Graduate Degree or equivalent combination of education and experience.
**PREFERRED EXPERIENCE** :
- 5-7 years of Program and/or Project management experience.
- Managed Care experience.
- Experience working in a cross functional highly matrixed organization.
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** :
- PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification and/or comparable coursework desired.
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 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/program management.
**Job Duties**
+ Active collaborator with people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.
+ Plans and directs schedules as well as project budgets.
+ Monitors the project from inception through delivery.
+ May engage and oversee the work of external vendors.
+ Focuses on process improvement, organizational change management, program management and other processes relative to the business.
+ Leads and manages team in planning and executing business programs.
+ Serves as the subject matter expert in the functional area and leads programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. Delivers the appropriate artifacts as needed.
+ Works with operational leaders within the business to provide recommendations on opportunities for process improvements.
+ Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
+ Generate and distribute standard reports on schedule
+ SQL Experience
+ Root Cause Analysis
**JOB QUALIFICATIONS**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent combination of education and experience.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
+ 3-5 years of Program and/or Project management experience.
+ Operational Process Improvement experience.
+ Healthcare experience.
+ Experience with Microsoft Project and Visio.
+ Excellent presentation and communication skills.
+ Experience partnering with different levels of leadership across the organization.
**PREFERRED EDUCATION** :
Graduate Degree or equivalent combination of education and experience.
**PREFERRED EXPERIENCE** :
- 5-7 years of Program and/or Project management experience.
- Managed Care experience.
- Experience working in a cross functional highly matrixed organization.
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** :
- PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification and/or comparable coursework desired.
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 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
Be The First To Know
About the latest Healthcare professionals Jobs in Post Falls !
6
Manager, Healthcare Analytics - Health Plan Integration - Remote
99207 Spokane, Washington
Molina Healthcare
Posted 6 days ago
Job Viewed
Job Description
**JOB DESCRIPTION**
**Job Summary**
Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to provider networks and other end users for operational and strategic analysis.
**KNOWLEDGE/SKILLS/ABILITIES**
Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the Health Plan. Resource to HCS staff for mentoring, coaching, and analysis questions. Responsible for staff time keeping, performance coaching, development, and career paths.
+ Daily management of Healthcare Analytics team.
+ Allocate new report/project requests (workload distribution).
+ Coordinates with Health Plan departments to meet data analysis and database development needs.
+ Reviews, evaluates, and improved Company business logic and data sources.
+ Resource to Health Plan staff for mentoring, coaching, and analysis questions.
+ Reviews Health Plan analyst work products to ensure accuracy and clarity.
+ Reviews regulatory reporting requirements and Health Plan project documentation.
+ Maintains reporting service level benchmarks for Healthcare Analytics team.
+ Represents Healthcare Analytics department in cross-departmental and operational meetings.
+ Serves as liaison between Corporate IT and Health Plan regarding reporting needs.
+ Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management.
+ Interfaces and maintains positive interactions with Health Plan and Corporate personnel.
+ Management Health Plan Encounter workflow process.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field
**Required Experience**
+ 3 years management or team leadership experience
+ 10 years' work experience preferable in claims processing environment and/or healthcare environment
+ Strong knowledge of SQL 2005/2008 SSRS report development
+ Familiar with relational database concepts, and SDLC concepts
**Preferred Education**
Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field.
**Preferred Experience**
3 - 5 years supervisory experience
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $88,453 - $206,981 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to provider networks and other end users for operational and strategic analysis.
**KNOWLEDGE/SKILLS/ABILITIES**
Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the Health Plan. Resource to HCS staff for mentoring, coaching, and analysis questions. Responsible for staff time keeping, performance coaching, development, and career paths.
+ Daily management of Healthcare Analytics team.
+ Allocate new report/project requests (workload distribution).
+ Coordinates with Health Plan departments to meet data analysis and database development needs.
+ Reviews, evaluates, and improved Company business logic and data sources.
+ Resource to Health Plan staff for mentoring, coaching, and analysis questions.
+ Reviews Health Plan analyst work products to ensure accuracy and clarity.
+ Reviews regulatory reporting requirements and Health Plan project documentation.
+ Maintains reporting service level benchmarks for Healthcare Analytics team.
+ Represents Healthcare Analytics department in cross-departmental and operational meetings.
+ Serves as liaison between Corporate IT and Health Plan regarding reporting needs.
+ Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management.
+ Interfaces and maintains positive interactions with Health Plan and Corporate personnel.
+ Management Health Plan Encounter workflow process.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field
**Required Experience**
+ 3 years management or team leadership experience
+ 10 years' work experience preferable in claims processing environment and/or healthcare environment
+ Strong knowledge of SQL 2005/2008 SSRS report development
+ Familiar with relational database concepts, and SDLC concepts
**Preferred Education**
Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field.
**Preferred Experience**
3 - 5 years supervisory experience
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $88,453 - $206,981 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
7
Specialist, Config Oversight (healthcare Medical claim audits)
99207 Spokane, Washington
Molina Healthcare
Posted 15 days ago
Job Viewed
Job Description
**Job Description**
**Work hours will be 7am-3:30pm PST M-F**
**Job Summary**
Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to contracting (benefit and provider), network management, credentialing, prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit interpretation within the audit process. Provide clear and concise results and comments to leaders about focal audits. Contributes to completion of audits as needed to ensure audits are conducted in a timely fashion and in accordance with audit standards.
**Job Duties**
- Reviews documentation regarding updates/changes to member enrollment, provider contract, provider demographic information, and/or claim processing guidelines. Evaluates the accuracy of these updates/changes as applied to the appropriate modules within the core processing system (QNXT).
- Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these updates/changes. Determines that all outcomes are aligned to the original documentation and allow appropriate processing.
- Conducts audits of vendor audits and verifies accuracy of their published outcomes are aligned to the documentation, various sources of truth and being assessed appropriately.
- Clearly documents the focal audit results and makes recommendations as necessary.
- Researches and tracks the status of unresolved errors issued on daily transactional audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance.
- Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. ( _Use for claims specific positions only_ )
- Prepares, tracks and provides audit findings reports according to designated timelines
- Presents audit findings and makes recommendations to management for improvements based on audit results.
**Job Qualifications**
**REQUIRED EDUCATION:**
Associate's Degree or equivalent combination of education and experience
**REQUIRED EXPERIENCE, SKILLS & ABILIITIES:**
+ Minimum 2 years as an operational auditor for at least one core operations function
+ Previous examiner/processing experience in at least one core operations functional area
+ Strong attention to detail
+ Knowledge of using Microsoft applications to include; Excel, Word, Outlook, Powerpoint and Teams
+ Ability to effectively communicate written and verbal
+ Knowledge of verifying documentation related to updates/changes within claims processing system .
+ Experience using claims processing system (QNXT).
**PREFERRED EDUCATION:**
Bachelor's Degree or equivalent combination of education and experience
**PREFERRED EXPERIENCE:**
3+ years healthcare Medical claims auditing
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
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.
**Work hours will be 7am-3:30pm PST M-F**
**Job Summary**
Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to contracting (benefit and provider), network management, credentialing, prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit interpretation within the audit process. Provide clear and concise results and comments to leaders about focal audits. Contributes to completion of audits as needed to ensure audits are conducted in a timely fashion and in accordance with audit standards.
**Job Duties**
- Reviews documentation regarding updates/changes to member enrollment, provider contract, provider demographic information, and/or claim processing guidelines. Evaluates the accuracy of these updates/changes as applied to the appropriate modules within the core processing system (QNXT).
- Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these updates/changes. Determines that all outcomes are aligned to the original documentation and allow appropriate processing.
- Conducts audits of vendor audits and verifies accuracy of their published outcomes are aligned to the documentation, various sources of truth and being assessed appropriately.
- Clearly documents the focal audit results and makes recommendations as necessary.
- Researches and tracks the status of unresolved errors issued on daily transactional audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance.
- Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. ( _Use for claims specific positions only_ )
- Prepares, tracks and provides audit findings reports according to designated timelines
- Presents audit findings and makes recommendations to management for improvements based on audit results.
**Job Qualifications**
**REQUIRED EDUCATION:**
Associate's Degree or equivalent combination of education and experience
**REQUIRED EXPERIENCE, SKILLS & ABILIITIES:**
+ Minimum 2 years as an operational auditor for at least one core operations function
+ Previous examiner/processing experience in at least one core operations functional area
+ Strong attention to detail
+ Knowledge of using Microsoft applications to include; Excel, Word, Outlook, Powerpoint and Teams
+ Ability to effectively communicate written and verbal
+ Knowledge of verifying documentation related to updates/changes within claims processing system .
+ Experience using claims processing system (QNXT).
**PREFERRED EDUCATION:**
Bachelor's Degree or equivalent combination of education and experience
**PREFERRED EXPERIENCE:**
3+ years healthcare Medical claims auditing
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
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.
View Now
8
Senior Analyst, Healthcare Analytics - Risk Adjustment (REMOTE)
99207 Spokane, Washington
Molina Healthcare
Posted 15 days ago
Job Viewed
Job Description
**JOB DESCRIPTION**
**Job Summary**
This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing risk score reporting with Databricks and Power BI, organizing and managing large and varied data sets, analyzing healthcare data for decision support, and communicating findings. Qualified candidates are the diligent problem solvers who have Databricks experience with advanced skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data. Collaborates with actuarial and operational staff to analyze, understand, modify, and communicate models and results. Makes recommendations to management based on relevant findings. Utilizes Power BI to display relevant reporting within a refresh cycle.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Compile and organize health care data using Databricks and Spark SQL programming, Notebooks, Workflows, Repositories, and other analytic / programming processes as needed.
+ Collect programming specifications from requestors to develop Notebooks, Workflows, and Power BI reporting using multiple data sources, crosswalks, and built-in validation checks.
+ Use peer-to-peer review process and end-user consultation to reduce errors and rework.
+ Assist with root cause analysis to maintain high integrity data and processes to minimize discrepancies and gaps.
+ Must have a strong attention to detail and knowledge of data structure and programming.
+ Understanding data storage and data sharing methods.
+ Converting data into usable information that is easy to understand.
+ Research and develop reports and analysis for senior management and effectively communicate results.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Finance, Economics, Computer Science
**Required Experience**
+ 5-7 years increasingly complex database and data management responsibilities
+ 5-7 years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metrics
+ Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare
+ Advanced knowledge of Databricks
+ Bachelor's Degree in Finance, Economics, Math, or Computer Science
**Preferred Experience**
Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:
+ Experience developing queries within project management tools like Azure DevOps.
+ Risk Adjustment experience and some familiarity with Power BI level report building, leveraging PBI to develop business insights.
+ Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc.
+ Analysis and forecasting of trends to provide analytic support for finance, pricing and actuarial functions.
+ Healthcare Analyst I experience desired.
+ PowerBI, Excel, Power Pivot, VBA, Macros, Copilot
+ Python, PySpark, R, SAS, or other programming language(s)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
#PJCorp
Pay Range: $77,969 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing risk score reporting with Databricks and Power BI, organizing and managing large and varied data sets, analyzing healthcare data for decision support, and communicating findings. Qualified candidates are the diligent problem solvers who have Databricks experience with advanced skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data. Collaborates with actuarial and operational staff to analyze, understand, modify, and communicate models and results. Makes recommendations to management based on relevant findings. Utilizes Power BI to display relevant reporting within a refresh cycle.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Compile and organize health care data using Databricks and Spark SQL programming, Notebooks, Workflows, Repositories, and other analytic / programming processes as needed.
+ Collect programming specifications from requestors to develop Notebooks, Workflows, and Power BI reporting using multiple data sources, crosswalks, and built-in validation checks.
+ Use peer-to-peer review process and end-user consultation to reduce errors and rework.
+ Assist with root cause analysis to maintain high integrity data and processes to minimize discrepancies and gaps.
+ Must have a strong attention to detail and knowledge of data structure and programming.
+ Understanding data storage and data sharing methods.
+ Converting data into usable information that is easy to understand.
+ Research and develop reports and analysis for senior management and effectively communicate results.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Finance, Economics, Computer Science
**Required Experience**
+ 5-7 years increasingly complex database and data management responsibilities
+ 5-7 years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metrics
+ Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare
+ Advanced knowledge of Databricks
+ Bachelor's Degree in Finance, Economics, Math, or Computer Science
**Preferred Experience**
Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:
+ Experience developing queries within project management tools like Azure DevOps.
+ Risk Adjustment experience and some familiarity with Power BI level report building, leveraging PBI to develop business insights.
+ Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc.
+ Analysis and forecasting of trends to provide analytic support for finance, pricing and actuarial functions.
+ Healthcare Analyst I experience desired.
+ PowerBI, Excel, Power Pivot, VBA, Macros, Copilot
+ Python, PySpark, R, SAS, or other programming language(s)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
#PJCorp
Pay Range: $77,969 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
9