Job Description Job Summary Responsible for collecting, storing, processing, and analyzing large sets of data. The primary focus will be on choosing optimal solutions to use for these purposes, then maintaining, implementing, and monitoring them. He/she will also be responsible to follow architecture and best practices used across the enterprise. Knowledge/Skills/Abilities: • Define ideal Architecture, Evaluating tools and Frameworks, Standards & Best Practices for implementing scalable business solutions• Implement Batch and Real-time data ingestion/extraction processes through ETL, Streaming, API, etc., …

Representative, Medication Therapy Management Services Molina HealthcareJob ID 2035964 JOB DESCRIPTION Job Summary : Contact Molina Healthcare members to schedule or warm transfer them to the completion of Adherence Reviews, Targeted Medication reviews (TRM’s) or Comprehensive Medication reviews (CMRs). Additionally, the role involves responding to inbound pharmacy-related calls from members providers, pharmacies and clinical staff while ensuring all interactions remain compliant with CMS and NCQA standards. Essential Job Duties • Educates Molina members on the urgency, positive impacts, and importance …

JOB DESCRIPTION Job SummaryProvides support for medical records collection activities. Supports quality improvement activities through outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties• Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records.• Loads medical records and reports …

Certified Coder CPC, CSS (Remote) Molina HealthcareJob ID 2036345 Molina Healthcare is hiring a Certified Coder. This role provides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties Performs on-going member medical chart reviews. Abstracts and reports ICD-10 and CPT diagnosis codes accurately and in compliance with established coding and billing principles …

Principal, System Engineering – Cloud Technical Chief of Staff – Remote Molina Healthcare Job ID 2035967 Job Description JOB SUMMARYProvide hands on technical coordination across engineering, platform, data, security, and operations teams. Focus on troubleshooting, solution alignment, and execution support. Partner with engineers and architects to resolve issues and move work forward. Support AI use case intake and evaluation in collaboration with architecture and AI governance teams. JOB DUTIES Coordinate technical work across application, platform, infrastructure, data, security, and vendor …

JOB DESCRIPTION Job Summary Provides lead level analyst support for configuration information management activities. Responsible for accurate and timely implementation and maintenance of critical information on claims databases, synchronizing operational and claims systems data and application of business rules as they apply to each database, validating data to be housed on databases, and ensuing adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements. Essential Job Duties Analyzes …

JOB DESCRIPTION Job Summary Provides advanced clinical and operational expertise to ensure delegated clinical functions – such as Utilization Management (UM), Care Management (CM), Behavior Health (BH), Disease Management (DM), and Quality programs – meet expected financial and clinical outcomes, organizational contractual, regulatory, and accreditation (NCQA, CMS, State) requirements. Leads end-to-end oversight activities, including performance monitoring, audits, corrective action management, risk identification, process improvement, and continuous performance optimization across delegated clinical entities. Partners with HCS clinical leaders, Finance, Medical Economics …

This internship falls within The Resource Group’s Strategic Sourcing Solution which focuses on contracting for the supplies and services that meet the criteria determined by caregivers. This group also continuously develops innovative approaches to contracting to further drive savings. Throughout the 12-week experience, interns will work on unique personal projects, collaborate with other interns to solve organizational challenges, and learn new business & professional skills. Information about the responsibilities for this internship can be found below: Learn price negotiation and …

Mi Terro Care Socks is an AI-powered smart wearable that detects diabetic and gout foot complications 48 hours before symptoms appear. Our sensor-embedded socks continuously monitor temperature, gait, and pressure — alerting patients and care teams to prevent ulcers, falls, and amputations. The Role We’re looking for a hungry, creative social media marketing intern who can build our brand from zero to viral. You’ll own our social presence across Instagram, TikTok, LinkedIn, X, and YouTube — creating content that educates, …