Manager, Appeals - Long Beach, United States - Molina Healthcare

Manager, Provider Appeals

4 days ago

**Remote and must live in the United States** · Job Summary · Responsible for leading, organizing and directing the activities of the Provider Appeals Unit that is responsible for reviewing and resolving provider complaints and communicating resolution in accordance with the stan ...

Manager, Appeals

1 week ago

Job Description · ***Remote and must live in the United States*** · JOB DESCRIPTION · Job Summary · Responsible for leading, organizing and directing the activities of the Provider Appeals Unit that is responsible for reviewing and resolving provider complaints and communicating ...

Manager, Provider Appeals

3 weeks ago

**_***Remote and must live in the United States***_** · **JOB DESCRIPTION** · **Job Summary** · Responsible for leading, organizing and directing the activities of the Provider Appeals Unit that is responsible for reviewing and resolving provider complaints and communicating reso ...

Appeals and Grievances Manager

3 weeks ago

JOB SUMMARY: Oversees the department work activities assuring compliance with all regulatory guidelines and policy protocols. Serves as the team leader for the team who receives, investigates, and responds to all member grievances & appeals. Responsible for the overall compliance ...

Appeals and Grievances Manager

2 weeks ago

JOB SUMMARY: Oversees the department work activities assuring compliance with all regulatory guidelines and policy protocols. Serves as the team leader for the team who receives, investigates, and responds to all member grievances & appeals. Responsible for the overall compliance ...

Manager II Grievance/Appeals

1 week ago

· Manager II Grievance/Appeals - Claims Support · Location: *CA Residential Requirement · This position will work a hybrid model (remote and office). Ideal candidates will live in the state of California within 50 miles of one of our PulsePoint locations. · The Manager II Grieva ...

Lead Spec, Appeals

2 weeks ago

Job Summary · Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider complaints and communicating resolution to members or authorized representatives in accordance with ...

Appeals & Grievances Health Claims Processing

2 weeks ago

**_Appeals & Grievances Health Claims Processing Specialist (REMOTE)_**Position Summary**: · Responsible for reviewing and resolving member and provider complaints and communicating resolution to members and providers (or authorized representatives) following the standards and re ...

Specialist, Member Rights

3 weeks ago

Job Description · Job Summary · The Specialist, Member Rights serves as a member advocate within the agency. This position ensures that members are informed of their rights and supports members through mediation and problem solving with interdisciplinary teams (IDTs). Maintains a ...

Vp, Marketplace Network Strategy and Services

1 week ago

Job Summary · Molina Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all re ...

Medical Director

2 weeks ago

Job Summary · Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provisions of medical staff services. Maintains a working knowledge of a ...

Medical Director

2 weeks ago

Job Summary · Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provisions of medical staff services. Maintains a working knowledge of a ...

Medical Director

2 weeks ago

Job Summary · Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provisions of medical staff services. Maintains a working knowledge of a ...

Medical Director, Behavioral Health

1 week ago

Job Summary · Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. · Kno ...

Fish Monger

2 weeks ago

At San Pedro Fish Market, the Fish Monger is responsible for ensuring that our fresh fish is properly cleaned, filleted and displayed while helping the company attain the highest levels of quality control and guest service. This position must follow directions from management and ...

Director, Vendor Management

3 weeks ago

Job Summary · The position will oversee and manage the Vendor Management team responsible of managing and coordinating the vendor activities between contracted entities and Molina Healthcare to support enrollment, claims, contact center, appeals and grievances, risk adjustment, m ...

Government Administration Manager

2 weeks ago

**TITLE** · GOVERNMENT ADMINISTRATION MANAGER · *** · Reports to AMM Director of Administration. Individual is responsible for overseeing all aspects of AMM operations utilized to provide Fiscal Intermediary services to assigned Government contracts, Fiscal Intermediary clients, ...

Community Property Manager- California

2 weeks ago

**Position**:Community Manager · **Category**:Exempt - Salary · **Supervisor**:Community Manager · **Hours**:Typical range of hours is based on the community needs and may require weekends and after hour emergency services. Workdays may be adjusted based on community needs. Full ...

Leasing Professional

3 weeks ago

This position is responsible for coordinating the community's marketing, leasing, and renewal strategies to achieve occupancy, revenue, and resident retention goals by performing all activities related to leasing to new residents, providing resident satisfaction throughout the te ...

Lead, Customer Experience

3 weeks ago

Job Summary · Provides customer support and stellar service to meet the needs of our Molina members and providers. · Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. · Provides product and service information, and ide ...