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11 Jobs in Lexington, KY

  • Medical Director, Behavioral Health

    Lexington, Kentucky
    ... , HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk ... leadership and guidance for utilization management and case management programs for mental health and ...
  • Sr Analyst, Healthcare Analytics (EST hours)

    Lexington, Kentucky
    ... presents healthcare utilization and cost containment reports and makes recommendations based on relevant ... /performance management metrics Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing ...
  • Program Manager, HCS CALIFORNIA

    Lexington, Kentucky
    ... _This Program Manager supports Medicaid and Medicare Healthcare Services Programs for our ... Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team ...
  • Customer Service Representative, Medicare Pharmacy (Remote)

    Lexington, Kentucky
    ... JOB DESCRIPTION Job Summary Molina Pharmacy Services/Management staff work to ... authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ...
  • Investigator, SIU (Remote)

    Lexington, Kentucky
    ... abuse. Coordinates with various internal customers (e.g., Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims) to gather documentation pertinent to investigations ...
  • Manager, Nurse Practitioner

    Lexington, Kentucky
    ... coworkers, clients, members, providers and customers Specific Duties: STAFF MANAGEMENT ... services to patients • Leads the NP's for the effective delivery of patient care services • Enforces ...
  • National Contracting Dir

    Lexington, Kentucky
    ... , signature support services, standards and resources to help Molina Healthcare successfully establish and ... : • Are aligned with our mission to provide quality health services to financially vulnerable families and ...
  • Sr Auditor, Delegation Oversight

    Lexington, Kentucky
    ... State Medicaid entities. Job Duties Oversees Utilization Management, Claims ... Administrative Service Organization for monitoring and auditing of Crisis Lines, Utilization Management, and ...
  • Sr Abstractor, HEDIS/Quality Improvement (Remote Opportunity)

    Lexington, Kentucky
    ... if preventive and diagnostic services have been correctly performed. • Works with the National ... 's degree or equivalent experience Required Experience • Min. 3 years experience in healthcare ...
  • Sr Architect, Info Systems - Databricks/SQL/Informatica/Risk & Quality - Remote

    Lexington, Kentucky
    ... change management processes. • Responsible to organize, manage and lead cross-team project tasks and ... position, please apply through the intranet job listing. Molina Healthcare offers a competitive ...
  • Sr Architect, Info Systems - .Net/Salesforce - Remote

    Lexington, Kentucky
    ... change management processes. • Responsible to organize, manage and lead cross-team project tasks and ... position, please apply through the intranet job listing. Molina Healthcare offers a competitive ...