Store Manager jobs in the Medical & Health category and Insurance industry

Remote position, not telephonic, must provide 10 home visits and live in the El Paso area Provides case management services to members with chronic or complex conditions including: Proactively identifies members that may qualify for potential case management services. Conducts assessment of member needs by collecting in-depth information from Molina's information system, the member, member's famil...
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Job Description Manager, Healthcare Services II JOB SUMMARY: Manages the day to day integrated team of health plan based staff responsible for cost effective delivery of healthcare services for Molina members. Oversees staff responsible for establishing clinical, financial and educational goals for members to achieve high quality patient care and optimal outcomes. Monitors information daily as app...
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Location: Irving, TX This is a non-remote position Job Summary Responsible for overseeing the Integrated Case Management staff focused on assisting Molina Healthcare members with their health care needs to achieve optimal clinical, financial and quality of life outcomes. Monitors information daily as appropriate including member metrics and staff productivity. Evaluates the services provided and o...
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Location: Albuquerque, NM Education Required: Not Indicated Experience Required: At least 5 years Position Description: BASIC FUNCTION: This position is responsible for developing and implementing Managed Care programs and strategies for Government Programs Clinical Operations; establishing cost-containment goals and objectives for the department along with policies, practices and procedures neede...
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Job Description Job Summary Responsible for safely and effectively transitioning Molina members from acute or inpatient care to lower levels of care and/or home in a cost efficient manner. Provides assessment, planning, implementation, coordination, monitoring, and evaluation of services for Molina members as they transition care and follows them for at least 30 days. Conducts an onsite hospital d...
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POSITION SUMMARY: Manages submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members and related outside agencies as a part of the integrated Healthcare Services Team. Conducts pertinent research, evaluates, responds and completes appeals and other inquiries accurately, timely and in accordance with all established regulatory guidelines. Prepares appeal s...
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