126 Healthcare jobs in Tooele

Job Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, belonging, integrity, quality and trust that are integral to our mission. EO/AA

This position provides assistive care to patients. The incumbent facilitates the efficient delivery of patient care, supports the professional role of the licensed staff, and provides support and assistance as directed by licensed staff in rendering basic healthcare to the patient. This position also assists with clerical functions as a multi-skilled auxiliary worker. This position provides direct patient care and may be required to access and administer medications within their scope of practice and according to state law.

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Responsibilities

Prepares patients for examinations and diagnostic procedures according to clinic procedures such as recording temperatures, pulse rate, blood pressure and responses to standardized medical history questions.

Reports all observed patient concerns and changes in condition to a licensed staff member.

Performs Clinical Laboratory Improvement Amendments (CLIA) Waved Lab tests as identified by department and reports results to the appropriate personnel.

Performs additional skills such as suture removal, straight catheterization and injections (IM, Subq and intra-dermal).

Acts as a chaperone for health care providers during patient examination as requested and assists with procedures.

Monitors and cleans assigned patient examination rooms, unit areas and unit equipment reporting outdated supplies, stock levels and restock set levels of items and necessary equipment repairs.

Answers telephones, forwards telephone messages and under the direction of licensed staff schedules appointments, procedures and diagnostic tests.

Assists in routine clerical functions such as filing of medical information in patient's records, locating and compiling department charts, obtaining medical records from other providers and entering charges for billing purposes.

Attends and completes mandatory education including infection prevention and control, safety, CPR, equipment usage and procedures according to hospital and department policies.

May perform patient phlebotomies in accordance with clinic procedures and physician orders after specialized training.

May apply leads and monitors for diagnostic procedures such as EKG and ultrasound scan under the direct supervision of licensed personnel.

May assist inpatient and family education by providing educational material and general health information to patients and family members.

May assist with transportation of patients to ancillary departments or inpatient units as directed by licensed staff.

May instruct in Basic Life Support (BLS) requirements.

May perform IV access.

May perform other duties based on department assigned.

Knowledge / Skills / Abilities

Ability to perform the essential functions of the job as outlined above.

Demonstrated phlebotomy skills.

Demonstrated human relation and effective communication skills.

Demonstrated proficiency in the specific clinic's specialty skills within six weeks of hire. *Specialty skills may not be performed until after the new hire completed basic competency testing.*

Ability to withstand the physical demand of being on your feet for long periods of time, of moving and lifting patients and of reaching for and handling equipment.

Qualifications Qualifications Licenses Required

Current RQI Healthcare Provider eCredential through the University of Utah Health RQI system. The eCredential is to be obtained within 30 days of hire.

One of the following:

• Current certification as a Certified Medical Assistant (CMA) through AAMA
• Currently credentialed in ABR-OE (Assessment-Based Recognition in Order Entry) through AAMA.
• Current certification as a Registered Medical Assistant (RMA) through AMT
• Current Clinical Medical Assistant Certification through NHA.
• Current certification as a NRCMA - Medical Assistant through the National Association for Health Professionals.
• Current certification to practice as a Paramedic in the State of Utah.
• Current Advanced EMT certification with the State of Utah.
• Current certification as a National Certified Medical Assistant (NCMA) through NCCT.

* Additional license requirements as determined by the hiring department.

Qualifications (Preferred) Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

This position involves intermediate working conditions in a healthcare setting that may exert up to 50 pounds and may consistently require lifting, carrying, pushing, pulling, or otherwise moving patients or objects, such as medical equipment, while providing patient care. Workers in this position may be exposed to infectious diseases and may be required to function around prisoners or behavioral health patients. Incumbents face exposure to potentially dangerous contaminated bodily fluids, blood, used needles and other contaminants as part of the daily hazards of the job.

Physical Requirements

Listening, Sitting, Speaking, Standing

Job Type

Full-time

Description

Pay: (pay is calculated based on certification status)

• Uncertified Case Managers start at $17.50 - Uncertified Case Managers will obtain certification within the first 90 days and pay will be increased
• Certified Case Manager range starts at $9.25 - Certified CM pay is calculated based on years of certified experience.

Schedule: Monday-Friday | 8am-5pm

Program: Tooele Outpatient

Benefits Highlights

• On-Demand Pay allows access to a portion of earned wages before the usual payday.
• Time off includes 15 days of annual accrued paid time off, which increases by one day with each year of service, 11 paid holidays, 2 wellness days, and paid parental leave.
• Full-time and part-time (30+ hours) team members are eligible for health, dental, vision, life & disability insurance, accident, hospital indemnity, critical illness, legal, auto, home, and pet insurance.
• Your out-of-pocket medical costs of up to 2000 for individuals and 4000 for families may qualify for reimbursement through our Garner HRA. In addition, based on the medical plan you choose, you can utilize pre-tax dollars to pay for eligible healthcare costs with an HSA, which includes a company match of up to 900 for individuals and 1800 for a family.
• We help our team members with tuition reimbursement, new licensure reimbursement, and career training and development. Valley also participates in Utah and federal student loan forgiveness programs.
• Our discounts and perks program provides more than 4500 in savings on everything from pizza to the zoo to movie tickets and oil changes!
• 401(k) retirement program allows for both pre-tax and post-tax contributions and includes a company match up to 6% of your annual salary.

Why Valley?

Since 1984, Valley Behavioral Health has helped thousands of adults, children, and families access high-quality behavioral health care. As the largest non-profit community behavioral health provider in the Intermountain Region, Valley offers a comprehensive range of services to ensure each individual receives the personalized care they need to heal and grow. You will belong in a community where you can be yourself, grow your career, and embrace new opportunities. Valley is committed to being an organization that promotes authenticity and encourages opportunities for success.

Job Summary & Deliverables

The Case Manager I is a certified position that provides targeted case management and psychosocial rehabilitative services as indicated by the care plan to support clients to meet their individualized goals. Certified Case Managers are responsible for utilizing evidence-based practices, meeting fiscal responsibilities and ensuring that regulatory compliance and organizational standards are met.

• Provides targeted case management services as described by the Medicaid manual
• Supports clients in following individualized care plans and identifying case management goals
• Completes documentation on services provided within Valley's standards
• Meets productivity expectations as assigned by supervisor
• Observes and collects client urine samples as necessary
• Transports clients to appointments as necessary

Requirements

Education

• High School diploma or equivalent

Experience

• None - see Preferred Qualifications

Licenses/Certification

• Case Manager certification
• CPR certification
• Valley de-escalation certification
• Driving positions require a minimum age of 21 and a current driver's license

Preferred Qualifications

• One year social services or behavioral health experience
• Bachelor's degree in Social Services, Psychology, or related field

Salary Description

17.50+ (DOE & CM Certification)

**Job Summary**
Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
+ Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion.
+ Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes.
+ May engage and oversee the work of external vendors.
+ Focuses on process improvement, organizational change management, program management and other processes relative to business needs.
+ Serves as a subject matter expert and leads healthcare services programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate. - Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs), user training materials and other related business documents.
**Required Qualifications**
+ At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
+ Strong analytical and problem-solving skills.
+ Strong organizational and time-management skills.
+ Ability to work in a cross-functional, professional environment.
+ Experience working within applicable state, federal, and third-party regulations.
+ Strong verbal and written communication skills.
+ Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
**Preferred Qualifications**
+ Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.
+ Leadership experience.
+ Medicaid/Medicare population experience.
+ Six sigma certification
+ Experience with Agile Methodology
+ Experience with Epic
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: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**JOB DESCRIPTION**
***Candidates must be located in California and work PST hours.***
**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.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Develops, implements, and uses software and systems to support the department's goals.
+ Develops and generates ad-hoc and standard reports using SQL programming, excel , Databricks and other analytic / programming tools.
+ Coordinates and oversees report generation by team members and distribution schedule to ensure timely delivery to customers, ensuring the highest quality on every project/request. Responsible for error resolution, follow up and performance metrics monitoring.
+ Provides peer review of critical reports and guidance on programming / logic improvements; provides guidance to team members in their analysis of data sets and trends using statistical tools and techniques to determine significance and relevance.
+ Applies process improvements for the team's methods of collecting and documenting report / programming requirements from requestors to ensure appropriate creation of reports and analyses while reducing rework.
+ Manage the creation of comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures.
+ Create new databases and reporting tools for monitoring, tracking, and trending based on project specifications.
+ Create comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures.
+ Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
+ Maintains SharePoint Sites as needed, including training materials and documentation archives.
+ Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of Healthcare.
+ Must be able to act as a liaison between Finance and Network Contracting as well as other external teams.
+ Must have experience in Financial modeling, identifying Utilization mgmt. trends and monitor pair mix.
+ Experience with Medicaid contract analytics is highly preferred.
+ Experience working on Managed care analytics and healthcare reimbursement models is required.
+ Must be able to work in a cross functional team.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Finance, Economics, Computer Science
**Required Experience**
+ 6+ years of progressive responsibilities in Data, Finance or Systems Analysis
+ Expert knowledge on SQL, PowerBI, Excel, Databricks or similar tools
**Preferred Education**
Bachelor's Degree in Finance, Economics, Math, Accounting or related fields
Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:
+ Proactively identify and investigate complex suspect areas regarding contract rate and related medical costs
+ Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan
+ Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, etc.
+ Analysis of trends in medical costs to provide analytic support for finance, pricing, and actuarial functions
+ Multiple data systems and models
+ BI tools (Power BI)
**Preferred License, Certification, Association**
QNXT or similar healthcare payer applications
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 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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.

**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 DESCRIPTION**
**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.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Develop ad-hoc reports using SQL programming, SQL Server Reporting Services (SSRS), Medinsight, RxNavigator, Crystal Reports, Executive Dashboard, and other analytic / programming tools as needed.
+ Generate and distribute standard reports on schedule using SQL, Excel, and other reporting software.
+ Create new databases and reporting tools for monitoring, tracking and trending based on project specifications.
+ Collects and documents report / programming requirements from requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce report writing errors and rework.
+ Responsible for timely completion of projects, including timeline development and maintenance; coordinates activities and data collection with requesting internal departments or external requestors.
+ Identify and complete report enhancements/fixes; modify reports in response to approved change requests; retain old and new report design for audit trail purposes.
+ Analyze data sets and trends for anomalies, outliers, trend changes and opportunities, using statistical tools and techniques to determine significance and relevance. Utilize extrapolation, interpolation, and other statistical methodologies to predict future trends in cost, utilization and performance. Provide executive summary of findings to requestors.
+ Create comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures.
+ Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
+ Maintains SharePoint Sites as needed.
**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
+ Basic knowledge of SQL
+ Preferred Education
+ Bachelor's Degree in Finance, Economics, Math, or Computer Science
**Preferred Experience**
Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:
+ Proactively identify and investigate complex suspect areas regarding medical cost issues
+ Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan
+ 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 in medical costs to provide analytic support for finance, pricing and actuarial functions
+ Healthcare Analyst I or Financial/Accounting Analyst I experience desired
+ Multiple data systems and models
+ BI tools
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 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 DESCRIPTION**
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases (using SQL, Excel, and QNXT). Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Generates and prepares provider-related data and reports (using SQL, Excel and QNXT) in support of Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry Research & Resolution, Provider Contracting/Provider Relationship Management).
+ Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations. Report examples may include: GeoAccess Availability Reports, Provider Online Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports.
+ Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree or equivalent combination of education and experience
**Required Experience**
+ 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration.
+ 3+ years' experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 5+ years managed care experience
+ QNXT; SQL experience
+ Crystal Reports for data extraction
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $45,390 - $88,511.46 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.