45 Healthcare jobs in Algonac
Medical Assistant - Wound Care - Contingent - Days
48047 Chesterfield, Michigan
Henry Ford Health System
Posted today
Job Viewed
Job Description
Medical Assistant Wound Care
While many wounds heal naturally, others require specialized care and can be highly resistant to traditional therapies. Chronic non-healing wounds can lead to life-threatening infection and limb loss. Henry Ford Wound Care and Hyperbaric Medicine at the Chesterfield health center offers advanced care and education relating to serious wounds caused by a medical condition, injury, radiation therapy, surgery, or impaired blood flow in the limbs.
By joining our team as a Medical Assistant, you will have the opportunity to make a meaningful impact on the lives of countless individuals while working in a dynamic and supportive environment.
General Summary:
Under direct supervision of the provider and nursing leadership, the Medical Assistant performs a variety of administrative and clinical tasks to assist in the quality and compassionate care provided to patients. These duties may include but are not limited to:
- Greeting and escorting patients to the exam room.
- Obtaining medical histories.
- The measurement and recording of vital signs.
- Preparing patients for an examination/procedure.
- Assisting the provider during the examination/procedure.
Shift Details: Monday to Friday 8:00 a.m. to 5:00 p.m.
Location: Mile Road Chesterfield, MI 48047.
Status: Contingent.
Education/Experience Required:
- High school diploma or G.E.D. equivalent.
- Basic computer knowledge and keyboarding skills preferred.
- Ability to perform a wide variety of clinical skills as related to ambulatory patient care preferred.
- Ability to problem-solve preferred. Possess effective interpersonal and communication skills preferred.
- EPIC (Electronic Medical Record) experience preferred.
- From the Hiring Manager: "Strong teamwork skills required, flexibility in changing patient acuity, eager to learn and grow professionally."
Additional Requirements:
Graduate of a Medical Assistant program with completion of a formal clinical externship (160 hour minimum). OR Graduate from a Medical Assistant program without completion of a clinical externship but with a minimum one-year experience in clinical medical assisting within the past five (5) years. OR Current Professionally Recognized Medical Assistant Certification with a minimum of five (5) years of experience in clinical medical assisting. OR Licensed Practical Nurse (LPN). OR Licensed Paramedic/Emergency Medical Technician (EMT) with at least one-year clinical experience in clinical medical setting within the past five (5) years. OR Military trained medical personnel with at least one-year clinical experience in clinical medical setting within the past five (5) years.
Certifications/Licensures Required:
Current BLS-C upon hire or successful completion by end of orientation.
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0
Grand Ledge Urgent Care - MEDICAL ASSISTANT
48837 Sterling Heights, Michigan
Sparrow Foundation
Posted today
Job Viewed
Job Description
Job Opportunity
Responsible for the efficient and effective processing of patients through the clerical and clinical areas of the practice/clinic. Under the general direction of the physician or advanced practice provider, provides high quality, compassionate patient care.
Essential Duties- Prepares patient for examination. Obtains vital signs and chief complaint. Appropriately documents information obtained.
- Performs laboratory and diagnostic testing.
- Answers, screens and triages telephone calls. Takes accurate messages and distributes to the appropriate personnel within the guidelines of the practice.
- Schedules tests and referral appointments for patients.
- Administers oral and injectable medication. Phones prescriptions to pharmacies.
- Engages and helps promote patient/family teaching as appropriate; and provides an educational environment for patients and patient families.
- Works gaps in care registries to help improve the quality of care.
- Maintains all logs and required checks (i.e., refrigerator temps, medications, oxygen, etc.)
- Maintains practice standards by participating in in-services, committees, etc. May assist in developing and implementing quality control and practice policies.
- Inventories, orders and restocks areas as necessary.
- Maintains and cleans equipment and environmental safety as required.
- Ability to provide clerical services and clinical services as required to maintain an effective practice flow. Cross trained to work both clerically and clinically.
- Must be able to float to all Urgent Care/Fast Care sites due to varying staffing/patient volumes.
This position requires 2 (two) years of Medical Assistant experience.
Urgent Care employees are required to float to multiple locations when individual staffing needs arise.
- All full time (0.9 FTE)/part time (0.6 FTE) staff need to pick up 3 weekend shifts in one-month period. Part time 0.3 FTE staff need to pick up 2 weekend shifts per month.
- Per Diem caregivers must work 1 (12 hours) shift per month
University of Michigan Health - Sparrow is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.
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1
Healthcare Services Operations Support Auditor
48311 Sterling Heights, Michigan
Molina Healthcare
Posted today
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
2
Healthcare Services Operations Support Auditor
48093 Warren, Michigan
Molina Healthcare
Posted today
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
3
Transition of Care Coach (RN) (Pacific Business hours)
48311 Sterling Heights, Michigan
Molina Healthcare
Posted 1 day ago
Job Viewed
Job Description
**JOB DESCRIPTION**
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from the acute setting to other settings, including nursing facility placement and private home, with the goal of reduced readmissions.
+ Ensures safe and appropriate transitions by collaborating with hospital discharge planners, as well as with hospitalists, outpatient providers, facility staff, and family/support network, as needed or at the request of member.
+ Ensures member transitions to a setting with adequate caregiving and functional support, as well as medical and medication oversight as required.
+ Works with participating ancillary providers, public agencies, or other service providers to make sure necessary services and equipment are in place for a safe transition.
+ Conducts face-to-face visits of all members while in the hospital and home visits of high-risk members post-discharge.
+ Coordinates care and reassesses member's needs using the Coleman Care Transitions Model recommended post-discharge timeline.
+ Educates and supports member focusing on seven primary areas (ToC Pillars): medication management, use of personal health record, follow up care, signs and symptoms of worsening condition, nutrition, functional needs and or Home and Community-based Services, and advance directives.
+ Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
+ Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
+ Facilitates interdisciplinary care team meetings and informal ICT collaboration.
+ RNs provide consultation, recommendations, and education as appropriate to non-RN case managers.
+ RNs are assigned cases with members who have complex medical conditions and medication regimens.
+ RNs will conduct medication reconciliation when needed.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
**Required Experience**
1-3 years hospital discharge planning or home health.
**Required License, Certification, Association**
+ Active, unrestricted State Registered Nursing (RN) license in good standing.
+ Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**CALIFORNIA State Specific Requirements: Must be licensed currently for the state of California. California is not a compact state.**
**Preferred Education**
Bachelor's Degree in Nursing
**Preferred Experience**
3-5 years hospital discharge planning or home health.
**Preferred License, Certification, Association**
Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM)
***Work schedule :M - F Pacific Business Hours**
**Candidates can live anywhere in the USA but must work PACIFIC hours.**
**California or West Coast USA Residents preferred**
***Remote, no travel required.**
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from the acute setting to other settings, including nursing facility placement and private home, with the goal of reduced readmissions.
+ Ensures safe and appropriate transitions by collaborating with hospital discharge planners, as well as with hospitalists, outpatient providers, facility staff, and family/support network, as needed or at the request of member.
+ Ensures member transitions to a setting with adequate caregiving and functional support, as well as medical and medication oversight as required.
+ Works with participating ancillary providers, public agencies, or other service providers to make sure necessary services and equipment are in place for a safe transition.
+ Conducts face-to-face visits of all members while in the hospital and home visits of high-risk members post-discharge.
+ Coordinates care and reassesses member's needs using the Coleman Care Transitions Model recommended post-discharge timeline.
+ Educates and supports member focusing on seven primary areas (ToC Pillars): medication management, use of personal health record, follow up care, signs and symptoms of worsening condition, nutrition, functional needs and or Home and Community-based Services, and advance directives.
+ Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
+ Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
+ Facilitates interdisciplinary care team meetings and informal ICT collaboration.
+ RNs provide consultation, recommendations, and education as appropriate to non-RN case managers.
+ RNs are assigned cases with members who have complex medical conditions and medication regimens.
+ RNs will conduct medication reconciliation when needed.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
**Required Experience**
1-3 years hospital discharge planning or home health.
**Required License, Certification, Association**
+ Active, unrestricted State Registered Nursing (RN) license in good standing.
+ Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**CALIFORNIA State Specific Requirements: Must be licensed currently for the state of California. California is not a compact state.**
**Preferred Education**
Bachelor's Degree in Nursing
**Preferred Experience**
3-5 years hospital discharge planning or home health.
**Preferred License, Certification, Association**
Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM)
***Work schedule :M - F Pacific Business Hours**
**Candidates can live anywhere in the USA but must work PACIFIC hours.**
**California or West Coast USA Residents preferred**
***Remote, no travel required.**
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
4
Transition of Care Coach (RN) (Pacific Business hours)
48093 Warren, Michigan
Molina Healthcare
Posted 1 day ago
Job Viewed
Job Description
**JOB DESCRIPTION**
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from the acute setting to other settings, including nursing facility placement and private home, with the goal of reduced readmissions.
+ Ensures safe and appropriate transitions by collaborating with hospital discharge planners, as well as with hospitalists, outpatient providers, facility staff, and family/support network, as needed or at the request of member.
+ Ensures member transitions to a setting with adequate caregiving and functional support, as well as medical and medication oversight as required.
+ Works with participating ancillary providers, public agencies, or other service providers to make sure necessary services and equipment are in place for a safe transition.
+ Conducts face-to-face visits of all members while in the hospital and home visits of high-risk members post-discharge.
+ Coordinates care and reassesses member's needs using the Coleman Care Transitions Model recommended post-discharge timeline.
+ Educates and supports member focusing on seven primary areas (ToC Pillars): medication management, use of personal health record, follow up care, signs and symptoms of worsening condition, nutrition, functional needs and or Home and Community-based Services, and advance directives.
+ Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
+ Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
+ Facilitates interdisciplinary care team meetings and informal ICT collaboration.
+ RNs provide consultation, recommendations, and education as appropriate to non-RN case managers.
+ RNs are assigned cases with members who have complex medical conditions and medication regimens.
+ RNs will conduct medication reconciliation when needed.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
**Required Experience**
1-3 years hospital discharge planning or home health.
**Required License, Certification, Association**
+ Active, unrestricted State Registered Nursing (RN) license in good standing.
+ Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**CALIFORNIA State Specific Requirements: Must be licensed currently for the state of California. California is not a compact state.**
**Preferred Education**
Bachelor's Degree in Nursing
**Preferred Experience**
3-5 years hospital discharge planning or home health.
**Preferred License, Certification, Association**
Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM)
***Work schedule :M - F Pacific Business Hours**
**Candidates can live anywhere in the USA but must work PACIFIC hours.**
**California or West Coast USA Residents preferred**
***Remote, no travel required.**
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from the acute setting to other settings, including nursing facility placement and private home, with the goal of reduced readmissions.
+ Ensures safe and appropriate transitions by collaborating with hospital discharge planners, as well as with hospitalists, outpatient providers, facility staff, and family/support network, as needed or at the request of member.
+ Ensures member transitions to a setting with adequate caregiving and functional support, as well as medical and medication oversight as required.
+ Works with participating ancillary providers, public agencies, or other service providers to make sure necessary services and equipment are in place for a safe transition.
+ Conducts face-to-face visits of all members while in the hospital and home visits of high-risk members post-discharge.
+ Coordinates care and reassesses member's needs using the Coleman Care Transitions Model recommended post-discharge timeline.
+ Educates and supports member focusing on seven primary areas (ToC Pillars): medication management, use of personal health record, follow up care, signs and symptoms of worsening condition, nutrition, functional needs and or Home and Community-based Services, and advance directives.
+ Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
+ Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
+ Facilitates interdisciplinary care team meetings and informal ICT collaboration.
+ RNs provide consultation, recommendations, and education as appropriate to non-RN case managers.
+ RNs are assigned cases with members who have complex medical conditions and medication regimens.
+ RNs will conduct medication reconciliation when needed.
**JOB QUALIFICATIONS**
**Required Education**
Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
**Required Experience**
1-3 years hospital discharge planning or home health.
**Required License, Certification, Association**
+ Active, unrestricted State Registered Nursing (RN) license in good standing.
+ Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
**CALIFORNIA State Specific Requirements: Must be licensed currently for the state of California. California is not a compact state.**
**Preferred Education**
Bachelor's Degree in Nursing
**Preferred Experience**
3-5 years hospital discharge planning or home health.
**Preferred License, Certification, Association**
Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM)
***Work schedule :M - F Pacific Business Hours**
**Candidates can live anywhere in the USA but must work PACIFIC hours.**
**California or West Coast USA Residents preferred**
***Remote, no travel required.**
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
5
Manager, Healthcare Analytics - Health Plan Integration - Remote
48093 Warren, Michigan
Molina Healthcare
Posted 5 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
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6
Senior Analyst, Provider Data Management -SQL/QNXT - Remote
48093 Warren, Michigan
Molina Healthcare
Posted 5 days ago
Job Viewed
Job Description
**JOB DESCRIPTION**
**Job Summary**
Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
+ Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
+ Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans.
+ Participates in the implementation and conversion of new and existing health plans.
**JOB QUALIFICATIONS**
**Required Education**
+ Bachelor's Degree in business administration, healthcare management, or a related field; or equivalent combination of education and experience
**Required Experience**
+ 5-7 years of business analysis experience
+ Proficiency in data analysis tools and techniques, such as Excel or SQL
+ Excellent communication, presentation, and interpersonal skills, with the ability to interact effectively with stakeholders at all levels
**Preferred Experience**
+ 7-9 years of business analysis 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.
#PJCore
Pay Range: $77,969 - $141,371 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
+ Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
+ Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans.
+ Participates in the implementation and conversion of new and existing health plans.
**JOB QUALIFICATIONS**
**Required Education**
+ Bachelor's Degree in business administration, healthcare management, or a related field; or equivalent combination of education and experience
**Required Experience**
+ 5-7 years of business analysis experience
+ Proficiency in data analysis tools and techniques, such as Excel or SQL
+ Excellent communication, presentation, and interpersonal skills, with the ability to interact effectively with stakeholders at all levels
**Preferred Experience**
+ 7-9 years of business analysis 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.
#PJCore
Pay Range: $77,969 - $141,371 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
7
Senior Analyst, Provider Data Management -SQL/QNXT - Remote
48311 Sterling Heights, Michigan
Molina Healthcare
Posted 5 days ago
Job Viewed
Job Description
**JOB DESCRIPTION**
**Job Summary**
Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
+ Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
+ Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans.
+ Participates in the implementation and conversion of new and existing health plans.
**JOB QUALIFICATIONS**
**Required Education**
+ Bachelor's Degree in business administration, healthcare management, or a related field; or equivalent combination of education and experience
**Required Experience**
+ 5-7 years of business analysis experience
+ Proficiency in data analysis tools and techniques, such as Excel or SQL
+ Excellent communication, presentation, and interpersonal skills, with the ability to interact effectively with stakeholders at all levels
**Preferred Experience**
+ 7-9 years of business analysis 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.
#PJCore
Pay Range: $77,969 - $141,371 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
+ Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
+ Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans.
+ Participates in the implementation and conversion of new and existing health plans.
**JOB QUALIFICATIONS**
**Required Education**
+ Bachelor's Degree in business administration, healthcare management, or a related field; or equivalent combination of education and experience
**Required Experience**
+ 5-7 years of business analysis experience
+ Proficiency in data analysis tools and techniques, such as Excel or SQL
+ Excellent communication, presentation, and interpersonal skills, with the ability to interact effectively with stakeholders at all levels
**Preferred Experience**
+ 7-9 years of business analysis 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.
#PJCore
Pay Range: $77,969 - $141,371 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
8
Manager, Healthcare Analytics - Health Plan Integration - Remote
48311 Sterling Heights, Michigan
Molina Healthcare
Posted 5 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
9