The intern will support the Medical Business Operations team by developing reporting templates and conducting research to assist with operational improvements. They will also track project timelines, collect action items from leadership meetings, and distribute assignments to ensure initiatives remain on schedule.
The intern will support the Mental Health Parity team in ensuring compliance with state and federal laws while collaborating with cross-functional stakeholders. They will also conduct research and develop tools to improve program scalability and audit readiness.
The intern will support provider network operations through outreach, education, and onboarding assistance. They will also conduct network performance analysis and create reports to provide actionable recommendations for the team.
The intern will support the Information Security organization with a focus on Identity and Access Management (IAM) initiatives. Responsibilities include assisting with access reviews, identity governance, security automation, and cybersecurity documentation.
Interns will perform meaningful work alongside talented professionals, including developing reports for the data analytics team and writing SQL. They will also work with internal databases and participate in special projects to gain industry insight.
The Lead Analyst provides technical business quality support by managing complex projects, developing test strategies, and ensuring high-quality deliverables. They also collaborate with business stakeholders to define requirements and mentor junior analysts to ensure project success.
The Director of Finance leads financial activities including analysis, reporting, forecasting, and modeling to support the Massachusetts Health Plan. They are responsible for managing finance staff, coordinating month-end closes, and ensuring all state and statutory reporting requirements are met.
Facilitates the research and resolution of member and provider appeals, grievances, and complaints in accordance with CMS and regulatory standards. Manages claims processing activities, including reviewing medical records and communicating outcomes to relevant stakeholders.
The architect will provide application security governance and support within the AppSec Center of Excellence to manage software supply chain risks. They will partner with development and DevOps teams to embed security controls and define secure-by-design patterns across the SDLC.
The Lead Analyst will design and develop predictive analytics systems to support Molina's prospective and retrospective risk adjustment interventions. They will also conduct root-cause analysis, manage data reporting modules, and provide training to team members on risk adjustment processes.
The Senior National Quality Performance Manager leads quality data collection, analytics, and reporting to drive performance improvement initiatives across the enterprise. They ensure program deliverables meet regulatory standards and collaborate with cross-functional teams to resolve complex quality issues.
Facilitate the research and resolution of member and provider appeals, grievances, and complaints in accordance with CMS standards. Ensure timely and accurate communication with stakeholders while maintaining compliance with regulatory and internal guidelines.
The specialist is responsible for the accurate validation and maintenance of provider information within claims and provider databases. They also audit provider records for quality and financial accuracy while supporting network administration projects.
Provides administrative and operational support for provider relations activities, including tracking deliverables, scheduling meetings, and maintaining documentation. Analyzes data to create reports and dashboards while assisting with provider outreach, education, and issue resolution.
Leads and manages a team responsible for employee leave and accommodation activities, ensuring compliance with federal and state laws. Provides high-level consultation to leadership and HR stakeholders while managing third-party administrator partnerships and internal policy alignment.
The Program Manager oversees the design, implementation, and ongoing operations of business programs while ensuring alignment with organizational goals and governance standards. They drive performance measurement, manage budgets, and collaborate with cross-functional teams to ensure effective program delivery and continuous improvement.
The Program Manager leads and manages Medicare Stars quality improvement initiatives by collaborating with cross-functional teams to meet performance goals. They are responsible for planning, executing, and monitoring program budgets, schedules, and outcomes while providing subject matter expertise to health plans.
The manager oversees and implements health plan quality improvement activities to ensure compliance with NCQA, federal, and state regulatory requirements. They lead cross-functional teams, monitor performance metrics, and prepare detailed reports for stakeholders and committees.
The Care Manager provides support for LTSS-specific activities and coordinates integrated care for members with high-need potential. They are responsible for conducting comprehensive assessments, developing care plans, and monitoring member progress toward desired health outcomes.
The Senior Specialist oversees, tracks, and reports on value-added benefits while providing senior-level support for member engagement and retention activities. They act as an advocate for members, resolving complex inquiries and grievances while collaborating with internal teams and external agencies.
Leads and supervises a team responsible for managing member and provider appeals and grievances in compliance with CMS and regulatory standards. Oversees business process audits, claims production standards, and the preparation of reports for committee presentations.
The Program Manager oversees the design, implementation, and governance of Marketplace Network Strategy initiatives to ensure alignment with organizational goals. They act as a business partner to leadership, managing cross-functional coordination, performance reporting, and resource prioritization.
The Product Owner is responsible for defining the product vision, managing the backlog, and ensuring technical solutions align with business outcomes and regulatory requirements. They serve as the primary bridge between business stakeholders and technical delivery teams throughout the full product lifecycle.
The Senior Analyst provides expert support for claims research activities, ensuring timely resolution of provider inquiries and issues. They conduct root-cause analysis, develop remediation strategies, and collaborate across departments to improve claims performance and compliance.
The IRIS Consultant builds relationships with participants to help them navigate the Wisconsin IRIS program and achieve their long-term care goals. They are responsible for developing customized care plans, managing budgets, and documenting all activities within the program's data system.
The IRIS Consultant builds relationships with participants to help them navigate the Wisconsin IRIS program and achieve long-term care goals. They are responsible for developing customized plans, managing budgets, and documenting all activities within the data system.
The Program Manager will lead healthcare services programs, ensuring compliance with regulatory standards and contractual commitments. They will collaborate with cross-functional teams to execute projects, manage vendor relationships, and implement quality initiatives.
The Senior Specialist provides support for government contract activities, including the development and administration of Medicaid, Medicare, and Marketplace programs. They are responsible for ensuring regulatory compliance, preparing reports, and coordinating research requests across internal and external stakeholders.
The Pharmacy Technician will conduct outbound calls to members to support medication adherence and coordinate prescription refills with pharmacies. They will also collaborate with providers and pharmacists to resolve claim issues and support Medication Therapy Management activities.
The Care Manager provides support for care coordination activities and collaborates with a multidisciplinary team to ensure integrated delivery of member care. They are responsible for conducting assessments, developing care plans, and monitoring member progress toward desired health outcomes.
