Molina Healthcare

Oversee and direct compliance activities, develop and implement compliance programs, and manage a team of compliance professionals. | Minimum 8 years in compliance or risk management, 3+ years of leadership experience, extensive regulatory knowledge, and project management skills. | JOB DESCRIPTION Leads and directs team responsible for compliance activities. Seeks to ensure the organization adheres to regulatory requirements, industry standards, and Molina internal policies, and prevents and/or detects violation of applicable laws and regulations, and protect the business from liability, fraudulent or abusive practices. Essential Job Duties • Directs and oversees compliance activities and serves as a resource on compliance issues. • Demonstrates leadership and expertise to ensure compliance with applicable state/federal statutes and internal policies. • Facilitates training and education, and subject matter expertise related to compliance requirements. • Ensures business accountability for compliance investigations - ensuring oversight, follow-up, and resolution. • Enforces the compliance plan, code of conduct and anti-fraud plan. • In conjunction with compliance leadership and the special investigative unit (SIU) team, develops an active relationship with third parties who have specific experience in conducting fraud, waste and abuse (FWA) investigations. • Prepares written quarterly reports to inform compliance leadership on the status of activities pertaining to overall compliance for area(s) of responsibility. • Oversees team of compliance professionals; responsible for hiring, performance management, recognition, and staff development. Job Requirements • At least 8 years of experience in compliance, risk management, and/or auditing, or equivalent combination of relevant education and experience. • At least 3 years management/leadership experience. • Extensive knowledge of relevant regulatory frameworks and industry standards. • Experience developing and implementing compliance programs and controls. • Strong leadership, strategic thinking, and decision-making capabilities. • Ability to thrive in a cross-functional highly matrixed environment. • Strong analytical and problem-solving skills. • Project management experience. • Ability to build rapport and gain the respect and collaboration of internal/external stakeholders. • Knowledge and ability to think creatively, proactively, and independently. • Ability to prepare reports and presentations and manage data. • Self-motivated and results oriented. • Strong organizational skills and the ability to meet delivery targets. • Disciplined and ability to effectively track, document and report on projects/activities. • Strong verbal and written communication skills. • Microsoft Office suite and applicable software program(s) proficiency. Preferred Qualifications • Previous experience in a health plan or government programs setting (Medicaid, Medicare, Marketplace). • Certificate in Healthcare Compliance (CHC), or other compliance-related certification. To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Oversee clinical and operational functions related to utilization, care, and quality programs, ensuring compliance, performance, and continuous improvement. | Requires RN licensure, clinical operations knowledge, and experience in performance management and process improvement. | JOB DESCRIPTION Job Summary Provides advanced clinical and operational expertise to ensure delegated clinical functions – such as Utilization Management (UM), Care Management (CM), Behavior Health (BH), Disease Management (DM), and Quality programs – meet expected financial and clinical outcomes, organizational contractual, regulatory, and accreditation (NCQA, CMS, State) requirements. Leads end-to-end oversight activities, including performance monitoring, audits, corrective action management, risk identification, process improvement, and continuous performance optimization across delegated clinical entities. Partners with HCS clinical leaders, Finance, Medical Economics and other internal business owners, Compliance, Quality, Legal and Executive Leadership to ensure vendors deliver high-quality, cost-effective, and compliant services to members. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties Provides advanced clinical and operational expertise to ensure delegated functions (UM, CM, BH, DM and Quality programs) meet clinical, financial, contractual, regulatory and accreditation requirements (NCQA, CMS, State). Conducts end-to-end oversight of delegated clinical entities, including performance monitoring, audits, corrective action plans (CAPs), and risk identification. Assesses business and operational impacts and needs related to the clinical delegation functions to identify opportunities to improve efficiency, accuracy, productivity, and effectiveness. Collaborates with internal partners to ensure high-quality, cost-effective vendor performance. Conducts Joint Operating Committees (JOCs) and other required meetings, and disseminates communications related to vendor performance, action plans, and improvement activities with key stakeholders. Reviews, researches, analyzes and evaluates delegated vendor information and processes, to assess compliance between a process or function and the corresponding written documentation. Uses analytical skills to identify variances. Uses problem-solving skills and business knowledge to make recommendations for process remediations or improvements. Uses understanding of key revenue levers, cost drivers and member and provider satisfaction impacts of business processes, to optimize and improve vendor performance. Employs change management techniques to prepare the business for successful organizational change initiatives. Translates metric-driven findings into actionable strategy recommendations for leadership and operational teams. Partners with Data/BI teams to enhance automation, data accuracy, and predictive analytics capabilities. Serves as the central point of escalation for vendor performance issues, coordinating with Clinical Operations, Quality, Compliance, IT, Finance, and Contracting. Collaborates with Contracting to optimize performance requirements, financial terms tied to outcomes, and measurable reporting standards. Required Qualifications At least 6 years of experience in health care, preferably in a clinical consultancy process improvement capacity, or equivalent combination of relevant education and experience. Registered Nurse (RN), license must be active and unrestricted in state of practice. Understanding clinical operations including utilization management and care management. Ability to provide hands-on, immersive, and direct support for identified business improvement initiatives. Experience in performance management activities and execution of corrective action plans. Strong leadership qualities and ability to lead and achieve results. Excellent verbal and written communications skills. Microsoft Office suite/applicable computer programs proficiency. Preferred Qualifications LEAN or Six Sigma certification. Experience in tracking and maintaining quality metrics. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Support care management and coordination activities, including assessments, care planning, and collaboration with healthcare teams. | Requires healthcare experience with persons with disabilities or long-term services, clinical licensure (LPN/LVN), and knowledge of community resources. | • Remote with field travel in some of Chippewa, Price, Rusk, & Taylor Counties, WI*** Job Description Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. • Facilitates comprehensive waiver enrollment and disenrollment processes. • Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. • Assesses for medical necessity and authorizes all appropriate waiver services. • Evaluates covered benefits and advises appropriately regarding funding sources. • Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. • Identifies critical incidents and develops prevention plans to assure member health and welfare. • Collaborates with licensed care managers/leadership as needed or required. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. • Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Demonstrated knowledge of community resources. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work independently, with minimal supervision and self-motivation. • Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications • Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. • Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $24 - $46.81 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leading provider relations activities, developing network strategies, and managing provider communication and education. | Extensive experience in healthcare data, analytics, cloud platforms, and leadership, but limited direct provider relations or managed care experience. | JOB DESCRIPTION Leads and directs team responsible for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures. Collaborates with network leadership and the corporate network team to develop and implement standardized provider relationship management and provider services for the health plan. Essential Job Duties • Oversees the plan’s provider relations function and team members. Responsible for the daily operations of the department, including leading and supporting various provider relations activities including provider education, outreach and inquiry resolution. • Develops health plan-specific provider relations strategies - identifying specialties and geographic locations to concentrate resources for the purposes of establishing a sufficient network of participating providers to serve the health care needs of the plan's members, and successfully develop and refine cost-effective and high quality strategic provider networks - ensuring establishment of both internal and external long-term partnerships. • Collaborates with health plan network management and operations teams and functional business unit stakeholders to lead and/or support various provider services functions and strategic initiatives with an emphasis on developing and implementing standards, resources, tools and best practices sharing across the organization. • Develops and deploys strategic network planning tools to drive provider services and contracting strategy across the organization. Facilitates planning and documentation of network management standards and processes for all line of business. • Provides matrix team support including, but not limited to: new markets provider/contract support services, resolution support, and national contract management support services. • Builds and/or facilitates provider communication, training and education programs for internal staff, external providers, and other stakeholders. • Ensures compliance with applicable company/plan business requirements including state/federal statutes, government sponsored program requirements, and network access standards. • Oversees and leads provider representatives activities, including developing and/or presenting policies and procedures, training materials, and reports to meet internal/external standards. • Assists with ongoing provider network development and the education of contracted network providers regarding plan procedures and claims payment policies. • Develops and implements tracking tools to ensure timely issue resolution and compliance with all applicable standards related to provider relations. • Oversees appropriate and timely interventions/communications when providers have issues or complaints (e.g., problems with claims and encounter data, eligibility, reimbursement, and provider website). • Serves as a resource to support the plan’s initiatives and helps to ensure regulatory requirements and strategic goals are realized. • Ensures appropriate cross-departmental communication of provider relations initiatives and contracted network provider issues. • Designs and implements programs to build and nurture positive relationships between contracted providers, ancillary providers, hospital facilities and the plan. • Develops and implements strategies to increase provider engagement in Healthcare Effectiveness Data Information Set (HEDIS) and quality initiatives. • Engages contracted network providers regarding cost control initiatives, medical cost ratio (MCR), non-emergent utilization, and Consumer Assessment of Healthcare Providers and Systems (CAHPS) to positively influence future trends. • Develops and implements strategies to reduce member access grievances with contracted providers. • Oversees the integrated health home (IHH) program and ensures IHH program alignment with department requirements, provider education and oversight. • Hires, trains, manages and evaluates team member performance - provides coaching, development, and recognition; ensures ongoing appropriate staff training, holds regular team meetings, and drives communication and collaboration. Required Qualifications • At least 8 years of provider services experience, including experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid and Medicare products, or equivalent combination of relevant education and experience. • At least 3 years of management/leadership experience. • Strong understanding of the health care delivery system, including government-sponsored health plans. • Experience with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc. • Previous experience with community agencies and providers. • Strong organizational skills and attention to detail. • Ability to manage multiple tasks and deadlines effectively. • Experience with preparing and presenting formal presentations. • Strong interpersonal skills, including ability to interface with providers and medical office staff. • Ability to work in a cross-functional highly matrixed organization. • Excellent verbal and written communication skills. • Microsoft Office suite and applicable software programs proficiency. Preferred Qualifications • Contract negotiation experience. Experience with Salesforce. Strong Excel skills - reporting & analysis. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $92,434 - $172,732.18 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leading and managing provider relations activities, developing strategies for network development, and ensuring compliance and provider engagement. | At least 8 years of provider services experience, including management, with strong healthcare system knowledge and communication skills. | JOB DESCRIPTION Leads and directs team responsible for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures. Collaborates with network leadership and the corporate network team to develop and implement standardized provider relationship management and provider services for the health plan. Essential Job Duties • Oversees the plan’s provider relations function and team members. Responsible for the daily operations of the department, including leading and supporting various provider relations activities including provider education, outreach and inquiry resolution. • Develops health plan-specific provider relations strategies - identifying specialties and geographic locations to concentrate resources for the purposes of establishing a sufficient network of participating providers to serve the health care needs of the plan's members, and successfully develop and refine cost-effective and high quality strategic provider networks - ensuring establishment of both internal and external long-term partnerships. • Collaborates with health plan network management and operations teams and functional business unit stakeholders to lead and/or support various provider services functions and strategic initiatives with an emphasis on developing and implementing standards, resources, tools and best practices sharing across the organization. • Develops and deploys strategic network planning tools to drive provider services and contracting strategy across the organization. Facilitates planning and documentation of network management standards and processes for all line of business. • Provides matrix team support including, but not limited to: new markets provider/contract support services, resolution support, and national contract management support services. • Builds and/or facilitates provider communication, training and education programs for internal staff, external providers, and other stakeholders. • Ensures compliance with applicable company/plan business requirements including state/federal statutes, government sponsored program requirements, and network access standards. • Oversees and leads provider representatives activities, including developing and/or presenting policies and procedures, training materials, and reports to meet internal/external standards. • Assists with ongoing provider network development and the education of contracted network providers regarding plan procedures and claims payment policies. • Develops and implements tracking tools to ensure timely issue resolution and compliance with all applicable standards related to provider relations. • Oversees appropriate and timely interventions/communications when providers have issues or complaints (e.g., problems with claims and encounter data, eligibility, reimbursement, and provider website). • Serves as a resource to support the plan’s initiatives and helps to ensure regulatory requirements and strategic goals are realized. • Ensures appropriate cross-departmental communication of provider relations initiatives and contracted network provider issues. • Designs and implements programs to build and nurture positive relationships between contracted providers, ancillary providers, hospital facilities and the plan. • Develops and implements strategies to increase provider engagement in Healthcare Effectiveness Data Information Set (HEDIS) and quality initiatives. • Engages contracted network providers regarding cost control initiatives, medical cost ratio (MCR), non-emergent utilization, and Consumer Assessment of Healthcare Providers and Systems (CAHPS) to positively influence future trends. • Develops and implements strategies to reduce member access grievances with contracted providers. • Oversees the integrated health home (IHH) program and ensures IHH program alignment with department requirements, provider education and oversight. • Hires, trains, manages and evaluates team member performance - provides coaching, development, and recognition; ensures ongoing appropriate staff training, holds regular team meetings, and drives communication and collaboration. Required Qualifications • At least 8 years of provider services experience, including experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid and Medicare products, or equivalent combination of relevant education and experience. • At least 3 years of management/leadership experience. • Strong understanding of the health care delivery system, including government-sponsored health plans. • Experience with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc. • Previous experience with community agencies and providers. • Strong organizational skills and attention to detail. • Ability to manage multiple tasks and deadlines effectively. • Experience with preparing and presenting formal presentations. • Strong interpersonal skills, including ability to interface with providers and medical office staff. • Ability to work in a cross-functional highly matrixed organization. • Excellent verbal and written communication skills. • Microsoft Office suite and applicable software programs proficiency. Preferred Qualifications • Contract negotiation experience. Experience with Salesforce. Strong Excel skills - reporting & analysis. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Lead logistics, performance improvement, and strategic initiatives for healthcare operations, focusing on NP scheduling and capacity management. | Requires 5+ years in logistics and 2+ years in leadership, with a relevant bachelor's degree; preferred master's. | Job Description Job Summary The Director of Logistics and Capacity leads and directs the logistics of Nurse Practitioner (NP) scheduling and capacity by utilizing process improvement methodologies in the analysis of current operations and design of improvement projects across all areas that impact operations. Works with various functional leaders and other members of the executive team to drive the execution of clinical initiatives across the organization. Provides analytical support to the strategy development process. Key areas of focus will include logistics, performance improvement, project planning and management, financial and operational analyses, corporate strategy development, and change management. Knowledge/Skills/Abilities • Provides logistics support for executive leadership and functional owners in the identification, development and execution of strategic actions. • Develops new business operational tools and train team members across the organization to leverage the use of the tools. • Develops and evaluates fact-based recommendations on NP scheduling and capacity and presents them to senior leadership to enable critical decisions. • Drives the execution of organizational change and strategic performance initiatives with necessary governance, oversight mechanisms, and process improvement efforts required to ensure the achievement of the organization's Operations team. • Works closely with the organization's functional leaders to help find solutions to the organization's toughest issues and provides internal consulting support for evaluation and implementation across the organization. • Leads critical initiatives requiring analytical and decision support to frame key issues, develop hypotheses, assess risks, conduct analyses, and test potential solutions prior to mobilizing commitment and designing broader implementation and engagement plans. • Utilizes change management principles, processes, tools, and identifies change strategies, assesses stakeholder impacts and organizational readiness, communicates with and trains facility participants, provides appropriate levels of support and supervision, and measures project effectiveness. • Performs other job-related duties as assigned or apparent. Ability to lead change while achieving business goals and objectives. • Exceptional qualitative and quantitative analysis skills. • Hands-on, results-oriented and pragmatic. • Creative, flexible, strategic thinker, able to work in a fast-paced, complex, and dynamic work environment. • Exceptional communication skills, both written and verbal, with excellent presentation skills and the ability to adapt to differing audiences. • Excellent listening skills with a strong ability to build cross-functional relationships.. Job Qualifications Required Education • Bachelor's degree in Logistics, Business, Healthcare, Engineering, Operations, Economics, or other similar, relevant disciplines required Required Experience • Five years of experience in logistics. • Two years of leadership or management experience. Preferred Education Master's degree preferred To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $123,083 - $240,011 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. By applying, you consent to your information being transmitted to the Employer by SonicJobs. See Molina Healthcare Privacy Policy at https://www.molinahealthcare.com/members/common/en-US/Pages/terms_privacy.aspx? and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions Remote Skills: Analysis Skills, Business Development, Business Operations, Business Strategy, Change Management, Clinical Nursing, Communication Skills, Compensation and Benefits, Consulting, Corporate Planning, Cross-Functional, Decision Support, Economics, Financial Analysis, Financial Operations, Healthcare, Leadership, Logistics, Nurse Practitioner, Operational Audit, Operations Planning, Performance Management, Presentation/Verbal Skills, Problem Solving Skills, Process Improvement, Project Planning, Qualitative Analysis, Quantitative Analysis, Risk Analysis, Strategic Analysis, Strategic Planning, Testing, Writing Skills About the Company: Molina Healthcare

Assist members with complaints and appeals, conduct intake and research, and educate members on services. | Requires 2 years of experience in customer service or healthcare systems, with a high school diploma, and a valid driver's license. | Job Description Job Summary Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials. Knowledge/Skills/Abilities • Maintains confidential telephone line to provide direct assistance to Members and/or family members who are unable to resolve their issues or complaints individually. Serves as an advocate in working with providers, regulatory agencies, outside agencies, co-workers and other departments as appropriate. Conducts in person meetings with Members and/or family members as appropriate. Logs all cases in a database. • Assists members in the complaint and appeal process. Determines the nature of the member's needs or problem; informs members of their rights in the complaints and appeals process; and advises/refers as appropriate for investigation and resolution. • Conducts focus groups in service delivery area as needed to ensure member needs are being addressed. • Educates members on covered services available to them, including preventive services. • Participates in annual member complaints and appeals training with health plan, including the member advocate/engagement role.. Job Qualifications Required Education High School diploma. Required Experience 2 years experience in customer service, consumer advocacy, and/or health care systems. Experience conducting intake, interviews, and/or research of consumer or provider issues. Basic understanding of managed healthcare systems and mental health issues. Required License, Certification, Association Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation. Preferred Education Associate's or Bachelor's Degree in Social Work, Human Services or related field. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $14.9 - $29.06 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leading and managing government contracts activities related to healthcare programs, ensuring compliance and reporting, and liaising with regulators. | Extensive experience in Medicaid, Medicare, or Marketplace programs, with management experience and knowledge of regulatory standards. | Job Description JOB DESCRIPTION Leads and directs team responsible for government contracts activities. Responsible for development and administration of contracts with state and/or federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations in designated Molina markets. Essential Job Duties • Leads and directs team responsible for management of regulatory and contractual requirements related to government programs including, but not limited to, Medicaid, Medicare, duals Medicare-Medicaid Program (MMP) and Marketplace, including reviewing and implementing new program requirements and ensuring the plan complies with all health plan contractual and regulatory reporting requirements. • Serves as the lead for health care program contractual and regulatory requirements, including performing the initial assessment and overseeing the implementation of all proposed and new contractual and regulatory standards, and ensuring the plan meets all filing requirements and ad hoc reporting requests in a timely manner and with quality deliverables. • Hires, onboards, trains, develops, mentors and performance manages reporting team of government contracts professionals and demonstrates accountability for team goals/deliverables. • Manages contract renewal activities. • Leads project teams involving staff from across the plan to implement new standards for which the government contracts department is accountable or otherwise involved. • Chairs committees and leads workgroups to carryout assigned responsibilities. • Assesses proposed state laws and regulations to determine potential impact, and provides written reports of findings to requesting plan and or corporate staff. • Develops department staff to serve as product line subject matter experts in research standards and program requirements. • Serves as a key liaison with state health care agencies and regulators. • Coordinates plan responses/reports to state health care agencies, regulators and partners regarding contractual and regulatory issues. • Identifies potential new business and bid opportunities. Required Qualifications • At least 8 years of experience in Medicaid, Medicare, and/or Marketplace health insurance/government programs, and5 years of experience in government health programs, or equivalent combination of relevant education and experience. • At least 3 years management/leadership experience. • Strong knowledge of Medicaid, Medicare, Marketplace and/or other government-sponsored programs and program compliance. • Ability to work cross-functionally in a highly matrixed environment. • Strong interpersonal skills. • Strong organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. • Analytical reasoning ability and detail orientation. • Proficient in compiling data, creating reports, and presenting information. • Excellent verbal and written communication skills, including ability to communicate and present to internal and external stakeholders. • Microsoft Office suite and applicable software programs proficiency. Preferred Qualifications • Legal/compliance-related experience. • Strong Medicaid-specific experience. • Experience with state/federal government relations and relationship building with key governmental representatives. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJHPO #LI-AC1

Leading logistics and capacity planning, process improvement, and strategic initiatives within a healthcare organization. | Requires at least 5 years of logistics experience, 2 years of leadership, and a relevant bachelor's degree. | Job Description Job Summary The Director of Logistics and Capacity leads and directs the logistics of Nurse Practitioner (NP) scheduling and capacity by utilizing process improvement methodologies in the analysis of current operations and design of improvement projects across all areas that impact operations. Works with various functional leaders and other members of the executive team to drive the execution of clinical initiatives across the organization. Provides analytical support to the strategy development process. Key areas of focus will include logistics, performance improvement, project planning and management, financial and operational analyses, corporate strategy development, and change management. Knowledge/Skills/Abilities • Provides logistics support for executive leadership and functional owners in the identification, development and execution of strategic actions. • Develops new business operational tools and train team members across the organization to leverage the use of the tools. • Develops and evaluates fact-based recommendations on NP scheduling and capacity and presents them to senior leadership to enable critical decisions. • Drives the execution of organizational change and strategic performance initiatives with necessary governance, oversight mechanisms, and process improvement efforts required to ensure the achievement of the organization's Operations team. • Works closely with the organization's functional leaders to help find solutions to the organization's toughest issues and provides internal consulting support for evaluation and implementation across the organization. • Leads critical initiatives requiring analytical and decision support to frame key issues, develop hypotheses, assess risks, conduct analyses, and test potential solutions prior to mobilizing commitment and designing broader implementation and engagement plans. • Utilizes change management principles, processes, tools, and identifies change strategies, assesses stakeholder impacts and organizational readiness, communicates with and trains facility participants, provides appropriate levels of support and supervision, and measures project effectiveness. • Performs other job-related duties as assigned or apparent. Ability to lead change while achieving business goals and objectives. • Exceptional qualitative and quantitative analysis skills. • Hands-on, results-oriented and pragmatic. • Creative, flexible, strategic thinker, able to work in a fast-paced, complex, and dynamic work environment. • Exceptional communication skills, both written and verbal, with excellent presentation skills and the ability to adapt to differing audiences. • Excellent listening skills with a strong ability to build cross-functional relationships.. Job Qualifications Required Education • Bachelor's degree in Logistics, Business, Healthcare, Engineering, Operations, Economics, or other similar, relevant disciplines required Required Experience • Five years of experience in logistics. • Two years of leadership or management experience. Preferred Education Master's degree preferred To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Designs, develops, and reviews enterprise application systems, ensuring stability, scalability, and performance, while leading cross-team projects and maintaining standards. | Requires 3+ years of technical implementation experience in enterprise environments, with a focus on application development, architecture, and team collaboration, which the candidate's profile does not fully match. | JOB DESCRIPTION Job Summary Designs and builds company specific enterprise application systems and technology expertise across multiple disciplines. Applies and promotes key principles (e.g., stability, scalability, performance, security, compatibility, re-use), helping ensure a balance between tactical and strategic technology solutions. Considers business problems “end-to-end”: including people, process, and technology, both within and outside the enterprise, as part of any design solution. Promotes use of industry and enterprise technology standards. Monitors emerging technologies for potential application within or across the Corporation. Adheres to design and application development standards, methodology and, framework within Architectural compliance and governance. KNOWLEDGE/SKILLS/ABILITIES Develops software (hands on code development) to meet key business objectives. Practices and leads SW and applications development methodologies in adherence to SW development standards. Designs and develops SW applications or systems solving specific business or processing problem (Web or Mobile). Gathers business requirements and develops conceptual design and technical design for multiple projects concurrently. Reviews computer system capabilities, work flow and scheduling limitations to determine if requested program or program change is possible within existing system. Conducts peer review of other developers (internal and contract staff) to ensure standards and quality. Responsible for quality deliveries for self and application engineers. Participates in build vs. buy evaluation process. Leads architecture and design discussions in adherence to SW development standards. Provides design and architectural expertise on application systems / technologies, to both technical teams and business partners. Responsible to support the application system / service owner for system performance, budgeting, and planning. Responsible for application system stability and scalability related activities. Responsible for alignment with project methodologies and change management processes. Responsible to organize, manage and lead cross-team project tasks and deliverables. Responsible for designing and building enterprise level application systems. Responsible for presentations and solutions submitted to technical peer review committees. Ownership to provide cross-organization teamwork, collaboration, communication, and leadership. Provides constructive feedback on people, process and technology for continuous improvement. JOB QUALIFICATIONS Required Education Bachelor's Degree in relevant field Required Experience 3+ years of hands-on technical implementation experience in mid to large IT Enterprise environments. 5-6 years of IT technical experience with IT enterprise infrastructure. Industry certifications preferred. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Manage provider relationships, conduct provider visits, resolve issues, and deliver training to enhance provider satisfaction and compliance. | At least 6 years of provider services experience, strong healthcare system knowledge, and excellent communication skills. | Job Description • Position requires travel throughout N Florida*** Job Summary Provides subject matter expertise and leadership for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures. Essential Job Duties • Successfully engages the plan's highest priority, high-volume and strategic complex provider community providers (including value-based payment (VBP) and other alternative payment method (APM) contracts to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers. • Serves as the primary point of contact between Molina health plan and the for non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers. • Collaborates directly with the plan's external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption. • Resolves complex provider issues that may cross departmental lines including contracting, finance, quality, operations, and may involve senior leadership. • Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members. • Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship. • Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters. • Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding). • Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs). • Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.). • Oversees and demonstrates accountability for provider satisfaction survey results. • Develops and deploys strategic network planning tools to drive provider relations and contracting strategy across the enterprise. • Facilitates strategic planning and documentation of network management standards and processes (effectiveness is tied to financial and quality indicators). • Works collaboratively with functional business unit stakeholders to lead and/or support various provider services functions with an emphasis on developing and implementing standards and best practice sharing across the organization. • Navigates the matrix team environment including: new markets provider/contract support services, resolution support, and national contract management support services. • Serves as a subject matter expert for the provider relations function. • Provides training, mentoring, and support to new and existing provider relations team members. • Role requires 20%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area). Required Qualifications • At least 6 years of provider services experience, including experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid, Medicare, and or Marketplace products, or equivalent combination of relevant education and experience. • Strong understanding of the health care delivery system, including government-sponsored health plans. • Experience with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc. • Previous experience with community agencies and providers. • Strong organizational skills and attention to detail. • Ability to manage multiple tasks and deadlines effectively. • Experience with preparing and presenting formal presentations. • Strong interpersonal skills, including ability to interface with providers and medical office staff. • Ability to work in a cross-functional highly matrixed organization. • Strong verbal and written communication skills. • Microsoft Office suite and applicable software programs proficiency. Preferred Qualifications • Management/leadership experience. • Contract negotiation experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJCorp Pay Range: $60,415 - $117,809 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Support care management activities through data analysis, reporting, and coordination with healthcare teams. | Requires RN licensure, healthcare experience, knowledge of EMR and HIPAA, and ability to work independently. | JOB DESCRIPTION Job Summary Field Position: Must reside in one of the following County • San Juan County to cover North • McKinley County to cover Northwest • Bernalillo County to cover Central • Chavez County to cover Southeast Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. • Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. • Conducts telephonic, face-to-face or home visits as required. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Maintains ongoing member caseload for regular outreach and management. • Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. • Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care, provides care coordination and assistance to member to address concerns. • May provide consultation, resources and recommendations to peers as needed. • Care manager RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). • Demonstrated knowledge of community resources. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and self-motivation. • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications • Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJHS2 Pay Range: $26.41 - $51.49 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Supports care management and coordination for members with high-need potential, including assessments, care planning, and collaboration with healthcare teams. | Requires healthcare experience, clinical licensure (LPN/LVN), and knowledge of community resources, which are not reflected in your background. | JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. • Facilitates comprehensive waiver enrollment and disenrollment processes. • Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. • Assesses for medical necessity and authorizes all appropriate waiver services. • Evaluates covered benefits and advises appropriately regarding funding sources. • Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. • Identifies critical incidents and develops prevention plans to assure member health and welfare. • Collaborates with licensed care managers/leadership as needed or required. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. • Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Demonstrated knowledge of community resources. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work independently, with minimal supervision and self-motivation. • Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications • Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. • Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJHS #HTF Pay Range: $24 - $46.81 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Support care management activities, develop care plans, and coordinate services across healthcare teams. | Requires RN licensure, healthcare care management experience, and understanding of EMR and community resources. | JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. • Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. • Conducts telephonic, face-to-face or home visits as required. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Maintains ongoing member caseload for regular outreach and management. • Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. • Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care, provides care coordination and assistance to member to address concerns. • May provide consultation, resources and recommendations to peers as needed. • Care manager RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). • Demonstrated knowledge of community resources. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and self-motivation. • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications • Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJNurse3 #HTF Pay Range: $26.41 - $51.49 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Assist with member enrollment activities, support outreach, and ensure documentation accuracy. | At least 3 years in healthcare or customer service, with experience in health insurance programs, and certification in NYSOH. | JOB DESCRIPTION Job Summary Provides senior level support for member enrollment activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health plan selection and enrollment processes, processing paperwork and ensuring documentation accuracy and follow-up. Also develops and maintains relationships with local community agencies, health care organizations, and county/state agencies that refer potential eligible members, and represents at community-based outreach events to aid enrollment efforts. Essential Job Duties • Assists with inbound/outbound calls as necessary to support facilitated enrollers with achievement of monthly, quarterly and annual member enrollment goals. • Leads projects and provides support to facilitated enrollers to meet enrollment targets. • Provides support across initiatives, including quality checks to marketing tracking and works with leadership to successfully support facilitated enrollers in enrollment goals/formulate resolutions for enrollers missing enrollment expectations; identifies challenges and communicates accordingly to leadership. • Successfully maintains and/or manages monthly facilitated enrollment calendar. • Demonstrates strong time-management skills including the ability to maintain multi-faceted projects - ensuring both quality and quantity deliverables, while completing job duties and adhering to various objectives with little to no supervision. • Participates in the design and implementation of enrollment-related process improvements within the current facilitated enrollment policies, procedures, services and workflows to improve the customer experience and productivity. • Maintains a high-level of professionalism in all internal/external communications. • Maintains expert knowledge of current enrollment-related processes, rules and regulations of all applicable plans/programs, serves as a resource for implementation, and provides training to facilitated enroller team. • Offers solutions to facilitated enrollment leadership regarding corrective action plans (CAPs), and conducts other quality activities to include policy and procedure and enrollment application reviews. • Performs research assignments as directed by facilitated enrollment leadership which may include but are not limited to sourcing educational resources and best practices for the enrollment team. • Monitors daily enrollment operations, identifies needs related to program tools/resources, and works with facilitated enrollment leadership to meet enrollment function needs and goals. • Meets with prospective members at various sites throughout applicable communities - providing education and support to prospective members navigating complexities of the health care system - assisting with the application process, explaining requirements and ensuring documentation completion. • Demonstrates comprehensive understanding of enrollment processes, best practices, and indications with minor errors. • Maintains high-regard for member privacy in accordance with the Health Insurance Portability and Accountability Act (HIPAA), and internal policies and procedures. • Local travel required. Required Qualifications • At least 3 years of experience in health care, and/or customer/provider services experience, including at least one year of experience working with state and federal health insurance programs and populations, or equivalent combination of relevant education and experience. • Completion of the New York State of Health Assistors (NYSOH) required training, certification and recertification required for the state of New York. • Must have reliable transportation and a valid driver's license with no restrictions. • Interpersonal/customer service skills. • Data processing and proofing experience. • Attention to detail, organizational and time-management skills, and ability to work independently and meet internal deadlines. • Positive attitude and ability to adapt to change. • Knowledge of managed care insurance plans. • Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities. • Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA). • Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers. • Effective verbal and written communication skills, including presentation skills. • Microsoft Office suite and applicable software programs proficiency. Preferred Qualifications • Team lead experience. • Previous experience enrolling members into managed care programs/health insurance. • Bilingual – Spanish and English. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $19.84 - $46.42 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Develops and manages healthcare data systems and analytics to support clinical and operational decision-making. | Requires a nursing license, experience with persons with disabilities or chronic conditions, and case management skills, which do not match your technical background. | • Sign on bonus available for eligible candidates*** • Field Travel throughout Dane County, WI*** Job Description Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. Knowledge/Skills/Abilities • Completes face-to-face comprehensive assessments of members per regulated timelines. • Facilitates comprehensive waiver enrollment and disenrollment processes. • Develops and implements a case management plan, including a waiver service plan, in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. • Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Promotes integration of services for members including behavioral health care and long term services and supports, home and community to enhance the continuity of care for Molina members. • Assesses for medical necessity and authorize all appropriate waiver services. • Evaluates covered benefits and advise appropriately regarding funding source. • Conducts face-to-face or home visits as required. • Facilitates interdisciplinary care team meetings for approval or denial of services and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns. • Identifies critical incidents and develops prevention plans to assure member's health and welfare. • Provides consultation, recommendations and education as appropriate to non-RN case managers • Works cases with members who have complex medical conditions and medication regimens • Conducts medication reconciliation when needed. • 50-75% travel required. Job Qualifications Required Education Graduate from an Accredited School of Nursing Required Experience • At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports. • 1-3 years in case management, disease management, managed care or medical or behavioral health settings. • Required License, Certification, Association • Active, unrestricted State Registered Nursing license (RN) in good standing • If field work is required, Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation. State Specific Requirements Virginia: Must have at least one year of experience working directly with individuals with Substance Use Disorders Preferred Education Bachelor's Degree in Nursing Preferred Experience • 3-5 years in case management, disease management, managed care or medical or behavioral health settings. • 1 year experience working with population who receive waiver services. Preferred License, Certification, Association Active and unrestricted Certified Case Manager (CCM) #PJHS To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $26.41 - $51.49 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Leading and managing multidisciplinary healthcare teams to ensure quality, cost-effective member care while maintaining compliance with regulations. | Requires at least 7 years of healthcare experience, 3 years in managed care, and clinical licensure or certification, with leadership experience. | Candidates Must Live In One Of The Following Regions Broward Monroe Manatee, Hillsborough, Polk, Hardee, Highlands Hamilton, Suwannee, Lafayette, Dixie, Columbia, Glichrist, Levy, Alachua, Union, Baker, Bradford, Levy, Citrus, Hernando, Lake, Volusia Sarasota, DeSoto, Charlotte, Glades, Lee, Hendry, Collier Pasco, Pinellas DeSoto, Glades Santa Rosa, Okaloosa, Washington, Liberty, Leon, Taylor, Madison, Wakulla, Escambia, Calhoun, Jefferson, Walton Palm Beach, Martin, St Lucie, Indian River, Okeechobee Miami-Dade Seminole, Orange, Osceola, Brevard Job Summary Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Responsible for leading and managing performance of one or more of the following activities: care review, care management, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), transition of care, health management, behavioral health, long-term services and supports (LTSS), and/or member assessment. • Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Molina clinical model. • Manages and evaluates team member performance, provides coaching, employee development and recognition, ensures ongoing appropriate staff training, and has responsibility for selection, orientation and mentoring of new staff. • Performs and promotes interdepartmental/multidisciplinary integration and collaboration to enhance continuity of care. • Oversees interdisciplinary care team (ICT) meetings. • Functions as hands-on manager responsible for supervision and coordination of daily integrated healthcare service activities. • Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators. • Collates and reports on care access and monitoring statistics including plan utilization, staff productivity, cost-effective utilization of services, management of targeted member population, and triage activities. • Ensures completion of staff quality audit reviews; evaluates services provided, outcomes achieved and recommends enhancements/improvements for programs and staff development to ensure consistent cost-effectiveness and compliance with all state and federal regulations and guidelines. • Maintains professional relationships with provider community, internal and external customers, and state agencies as appropriate, while identifying opportunities for improvement. • Local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 7 years experience in health care, and at least 3 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. • At least 1 year of health care management/leadership experience. • Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • Experience working within applicable state, federal, and third party regulations. • Demonstrated knowledge of community resources. • Proactive and detail-oriented. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and demonstrate self-motivation. • Responsive in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving and critical-thinking skills. • Excellent verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. • Medicaid/Medicare population experience. • Clinical experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJHS Pay Range: $73,102 - $142,549 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Oversee and lead a sales and outreach team to drive membership growth and community engagement in a regulated healthcare environment. | Minimum 5-7 years in sales or outreach, experience managing teams, and familiarity with healthcare or community outreach, none of which align with your merchandising expertise. | Job Description Job Summary The Manager, Business Development, Facilitated Enrollments, is responsible for for overseeing daily operations and driving individual and team performance. The Manager will lead a team of Facilitated Enrollers in a designated region(s) making data-informed decisions to drive performance, resource allocation and lead generation. This is a field-based leadership role that is accountable for meeting sales and enrollment targets, as well as increasing market share, leveraging product and market synergies driving overall membership growth and retention. Leads managed-care related business development activities for competitive intelligence, which may also include attendance/participation national, state, and local conferences, seminars, and meetings as well as any other business development support activities, as needed. Job Duties Manage and oversee a local field-based team of Facilitated Enrollers that orchestrate member events, potential customer events, and community-based goodwill and general awareness that make Molina the insurer of choice Leads business development support projects from inception through completion. Develop and execute effective business plans to reflect strategy, tactics, key relationships, and commensurate resources for the respective region. This will include goals, recruitment, sales/business development events, market partnerships, and engagement Conduct regular sales-related training/coaching, focusing on increasing sales, overcoming objections, expanding markets, selling the full portfolio, presentations skills, prospecting, compliance and quality updates, etc. Build, maintain, deepen, and leverage internal and external strategic relationships that create sales opportunities. Leads analyses and market research utilized for business development activities. Gathers research and intelligence, including monitoring activity in other markets. Create and execute effective resource sharing strategies, including lead routing, kiosk assignments, community meeting assignments, and participation in other Molina best practices. Collaborate with the Marketing team to produce positive outcomes, notably lead generation, member enrollment, and membership growth Focus on professional development of the team and mentoring the Facilitated Enrollers Develop and implement provider engagement strategies Ensure compliance with state regulations as well as health plan policies and procedures Job Qualifications REQUIRED EDUCATION: Bachelor’s Degree or equivalent work experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: Minimum 5-7 years sales or sales experience (Demonstrated experience managing a team of sales and/or outreach staff with KPIs in a regulated environment) Minimum 5-7 years of business to business, business to consumer direct marketing, outside sales, or community outreach experience Demonstrated Proficiency in Microsoft Office; Agility in the use of data management databases (i.e. SharePoint, PowerBi). Strong communication skills, including written, phone and video to manage and engage with corporate and external partners (ie Providers, community based organizations, etc…) in a culturally competent manner Strong relationship building skills and ability to work engage customers and prospective members Ability to manage and prioritize deliverables Effective in sourcing and use of market research information and market strategies Prior experience in structured sales, service, or business development Experience in a deadline-driven environment to meet or exceed sales promotion/marketing targets in compliant manner within a heavily regulated marketplace. Understanding of Individual Exchange, Medicaid, and NY State of Health Marketplace Able to travel State wide up to 80% of the time within assigned sales territories REQUIRED LICENSE, CERTIFICATION, ASSOCIATION: Must have reliable transportation and a valid state driver's license with no restrictions meeting Molina requirements PREFERRED EDUCATION: Graduate Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: Understanding of the healthcare industry Bilingual skills Local market experience Experience working with communities of all different ethnicities, cultural backgrounds, diverse populations, and/or underserved communities Creative thinker with proven track record of innovative ideas working within structured (including matrixed organizations), high velocity environments To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Leading enterprise safety, security, and risk management programs, including safety operations, security oversight, and crisis response. | Extensive leadership experience in safety and security programs, certifications like CSP or CPP, and experience managing large-scale operations in a matrixed environment. | JOB DESCRIPTION JOB SUMMARY Leads and directs the development and execution of integrated strategies for workforce risk, safety, and security within Molina’s Healthcare’s Protection Services. Provides strategic direction and enterprise oversight of programs that protect Molina’s people, facilities, and operations across all work environments. Ensures regulatory compliance, operational continuity, and a culture of care and preparedness. Responsibilities include enterprise workforce risk management, occupational health and safety, emergency response planning, site and event security, workplace violence prevention, and de-escalation programs. Oversees a multidisciplinary team, and partners with executives, business leaders, and cross-functional stakeholders to anticipate and mitigate risks, enhance organizational resilience, and advances employee well-being and safety across the enterprise. ESSENTIAL JOB DUTIES Workforce Risk Provides strategic leadership and oversight for enterprise workforce risk management programs designed to identify, assess, and mitigate operational and employee risk across the organization. Directs programs supporting in-person, remote and field employees, including ergonomic risk management, infectious disease case management, and third-party motor vehicle record oversight. Manages the design and maintenance of enterprise Emergency Response Plans and business continuity support programs, ensuring readiness for disruptive events. Leads the design and delivery of enterprise de-escalation and workplace violence prevention programs, ensuring alignment with organizational learning principles and enterprise risk management frameworks. Collaborates with Human Resources, Legal, Compliance, and other key stakeholders to integrate risk considerations into policies, standards, and employee engagement strategies. Partners with executive leadership to develop proactive communication, metrics, and governance mechanisms that promote early intervention and accountability. Serves as backup to lead the cross functional Threat Management Team with HR, Legal, & Investigations Safety Manages and oversees consultants and senior consultants to ensure delivery of day-to-day safety and compliance programs. Provides enterprise leadership and direction for occupational safety and health programs, ensuring compliance with OSHA and applicable federal and state requirements. Oversees enterprise injury and illness prevention, accident investigation, job hazard analysis, and ergonomic assessment initiatives. Leads the development, implementation, and evaluation of safety training programs, including CPR/AED/first aid certification, ergonomics, and emergency response education. Leads continuous improvement efforts using metrics, audit results, and after-action reviews to drive program maturity and operational excellence. Ensures integration of workforce safety initiatives into corporate strategy, aligning with Molina’s mission, regulatory obligations, and employee experience priorities. Security Provides oversight and governance for Molina’s site and event security operations, including contract guard force management, and special event security planning. Manages supplier relationships and security service agreements, ensuring cost-effective delivery and operational excellence. Directs responses to security and safety incidents, ensuring proper investigation, documentation, and compliance with legal and regulatory requirements. Serves as a senior liaison with law enforcement, emergency services, and external partners during incidents and enterprise-level responses. Supports enterprise crisis management and business continuity functions during disruptive events, ensuring coordination and leadership within the Protection Services organization. Team Administration Leads and mentors the in-house safety and security managers and professionals, ensuring high performance, professionalism, and alignment with organizational priorities. Ensures appropriate consultation regarding threat mitigation, workplace violence, and regulatory compliance. Regularly reports compliance metrics to senior leadership ensuring trends and threats are identified with recommendations for mitigation. Prepares and manages operational budget including forecasting, staffing and third-party expense management. Oversee the inventory, accountability, and logistics of Workforce Risk, Safety, and Security tools, technology, and equipment. JOB QUALIFICATIONS REQUIRED QUALIFICATIONS At least 8 years demonstrated leadership in programs at a national or enterprise level; at least 5 years’ experience with safety program and safety management systems (SMS); at least 5 years’ experience with project management, including implementation/project management of safety solutions in facilities; at least 3 years’ experience managing in a matrixed environment, or equivalent combination of relevant education and experience. Large scale safety operations in a multinational company environment. Worked across functions in a matrixed organization, commensurate with a Fortune 500. Nationally recognized safety certification such as Associate Safety Professional (ASP), Certified Safety Professional (CSP), Safety Management Specialist (SMS), Certified Training Professional (CTP), and Certified Protection Professional (CPP) Demonstrated ability to provide strategic direction, influence decision-making, and lead enterprise-level program development Exceptional communication, facilitation, and relationship—building skills with proven ability to collaborate across diverse business units Demonstrated leadership presence and ability to thrive in a fast-paced, ambiguous environment Proficient in MS Office applications (Outlook, Word, Excel, PowerPoint) and familiar with SharePoint and Visio Strong analytical, problem-solving, and decision-making skills, with the ability to drive measurable outcomes PREFERRED QUALIFICATIONS: Proficient in incident management, case tracking, and analytic systems (e.g., Salesforce, Ontic) Knowledge of OSHA, ISO45001, ANSI Z20, ASIS, and other applicable state and federal safety, security, and health standards To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Support care management and coordination activities for members with high-need potential, including assessments, care planning, and interdisciplinary collaboration. | Requires healthcare experience, clinical licensure, and knowledge of community resources, which do not align with your technical background. | JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. • Facilitates comprehensive waiver enrollment and disenrollment processes. • Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. • Assesses for medical necessity and authorizes all appropriate waiver services. • Evaluates covered benefits and advises appropriately regarding funding sources. • Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. • Identifies critical incidents and develops prevention plans to assure member health and welfare. • May provide consultation, resources and recommendations to peers as needed. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years experience in health care, including at least 1 year of experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. • Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT, Doctor of Psychology (PhD or PsyD) or equivalency based on state contract, regulation, or state board licensing mandate. License must be active and unrestricted in state of practice. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Demonstrated knowledge of community resources. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and self-motivation. • Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. • In some states, must have at least one year of experience working directly with individuals with substance use disorders. Preferred Qualifications • Certified Case Manager (CCM). • Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.