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Louisville, Kentucky
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, 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
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Louisville, Kentucky
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operational management and oversight of integrated Healthcare Services (HCS) teams responsible for providing ... effective utilization of services, management of targeted member population, and triage activities
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Louisville, Kentucky
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presents healthcare utilization and cost containment reports and makes recommendations based on relevant ... /performance management metrics
Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing
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Louisville, Kentucky
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JOB DESCRIPTION
Job Summary
Molina Pharmacy Services/Management staff work to ... requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy
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Louisville, Kentucky
...
JOB DESCRIPTION
Job Summary
Molina Pharmacy Services/Management staff work to ... requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy
...
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Louisville, Kentucky
...
JOB DESCRIPTION
Job Summary
Molina Pharmacy Services/Management staff work to ... authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management
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Louisville, Kentucky
...
JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with members ... , unrestricted Utilization Management Certification (CPHM).
To all current Molina employees: If you are
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Louisville, Kentucky
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abuse.
Coordinates with various internal customers (e.g., Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims) to gather documentation pertinent to investigations
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Louisville, Kentucky
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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
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Louisville, Kentucky
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, 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
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Louisville, Kentucky
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State Medicaid entities.
Job Duties
Oversees Utilization Management, Claims ... Administrative Service Organization for monitoring and auditing of Crisis Lines, Utilization Management, and
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Louisville, Kentucky
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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
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Louisville, Kentucky
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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
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Louisville, Kentucky
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services, the Member Navigator will communicate with members and caregivers to uncover and act on possible ... knowledge of medical terminology and healthcare landscape preferred
Excellent written and verbal
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West Louisville, Kentucky
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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
...
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West Louisville, 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
...
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Louisville, 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
...
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Louisville, 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
...
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Louisville, Kentucky
...
providers for all states where services are provided.
• Monitors and tracks expiration/renewal dates of ... , please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and
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Louisville, Kentucky
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Health plans and Corporate Healthcare functions,
• Requires highest level understanding of ... .
• Maintains management/technical skills that can be utilized in the field to solve complex problems
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Louisville, Kentucky
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if preventive and diagnostic services have been correctly performed.
• Works with the National ... experience
Required Experience
• Min. 3 years experience in healthcare with minimum 2 years
...
