• Medical Director

    Molina Healthcare (Tacoma, WA)
    …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
    Molina Healthcare (08/20/25)
    - Related Jobs

  • Senior Medical Director (Medicare)

    Molina Healthcare (Vancouver, WA)
    …10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization decisions are rendered… more
    Molina Healthcare (06/13/25)
    - Related Jobs

  • Manager, Provider Network Administration (Remote)

    Molina Healthcare (WA)
    …equivalent combination of education and experience **Required Experience** * 5-7 years managed care experience, including min. 2 years of supervisory experience ... Association** N/A **Preferred Education** Bachelor's Degree **Preferred Experience** * 7+ years managed care experience * QNXT; SQL experience * Crystal Reports… more
    Molina Healthcare (08/13/25)
    - Related Jobs

  • Director, Performance Suite Analytics

    Evolent (Olympia, WA)
    …professional experience in claims-based healthcare analytics with a payer, provider, vendor, managed care , or related healthcare consulting entity + Extensive ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
    Evolent (07/09/25)
    - Related Jobs

  • Investigator, Special Investigative Unit…

    Molina Healthcare (Vancouver, WA)
    …investigative and law enforcement procedures with emphasis on fraud investigations. + Knowledge of Managed Care and the Medicaid and Medicare programs as well as ... investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. Duties include performing accurate and reliable… more
    Molina Healthcare (08/15/25)
    - Related Jobs

  • VP, Clinical Operations

    Molina Healthcare (Spokane, WA)
    …related field **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 10 years managed care experience with management responsibility including clinical ... members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including physical health and behavioral health, for members… more
    Molina Healthcare (07/17/25)
    - Related Jobs

  • Sr. Business Development Manager - Medicaid,…

    Amazon (Seattle, WA)
    …experience preferably in PBM, health insurance, pharmacy, business development, marketing, managed care , Medicaid, Medicare Part D, and commercial innovation. ... and partner with internal stakeholders to fix - Drive RFP and contracting administration - Strong LP's include: Deep Dive, Customer Obsession (both partner… more
    Amazon (06/11/25)
    - Related Jobs

  • Program Controls Manager

    Stantec (Seattle, WA)
    When you care deeply about the work you do, it's rewarding to see it through from concept to completion. We partner with clients to provide both program management ... transit systems, water treatment facilities, mines, and wind farms, we've successfully managed thousands of projects. Joining our team, turning visionary ideas into… more
    Stantec (08/07/25)
    - Related Jobs

  • Deputy Program Manager

    Stantec (Seattle, WA)
    When you care deeply about the work you do, it's rewarding to see it through from concept to completion. We partner with clients to provide both program management ... transit systems, water treatment facilities, mines, and wind farms, we've successfully managed thousands of projects. Joining our team, turning visionary ideas into… more
    Stantec (08/07/25)
    - Related Jobs

  • Director, Appeals & Grievances (Medicare…

    Molina Healthcare (Everett, WA)
    …supervisory/management experience with appeals/grievance and/or claims processing within a managed care setting. **Preferred Education** Bachelor's degree ... with local Health Plan requirements * Works with Claims, Configuration, Contracting , Provider Data Management, and other business partners to resolve provider… more
    Molina Healthcare (07/18/25)
    - Related Jobs