- Molina Healthcare (Columbus, OH)
- …**Job Summary** The Delivery Manager will be responsible in delivering various technical projects that involves in (Compute, Storage, Network, Data Management) ... migration to Azure. The incumbent in this role will be closely working with PMO, Project technical team in delivering our key initiatives. The Delivery Manager will drive the deliverables with technical knowledge in the below areas. * Manage delivery of… more
- Molina Healthcare (OH)
- …guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed ... identify trends or discrepancies related to over- or underpayment. + Utilize QNXT to research claims history, provider contract setup, and benefits configuration. +… more
- Molina Healthcare (Columbus, OH)
- …automated process and manual input + Ensure quality control of data entered into QNXT and sent to external vendors + Oversees and participates in state, federal, and ... State, Federal, and business regulatory requirements and strong system knowledge of QNXT and other state specific applications concerning Managed Care Enrollment. +… more
- Molina Healthcare (OH)
- …as applied to the appropriate modules within the core processing system ( QNXT ). * Conducts focal audits on samples of processed transactions impacted by ... claims processing system . + Experience using claims processing system ( QNXT ). **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and… more
- Molina Healthcare (Akron, OH)
- …of Claims or Adjustment experience in Medicare and/or Medicaid + Familiarity with QNXT , iServe, Project Management 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: $21.82 - $51.06 /… more
- Molina Healthcare (Cleveland, OH)
- …Education** Bachelor's Degree **Preferred Experience** + 5+ years managed care experience + QNXT ; SQL experience + Crystal Reports for data extraction 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.… more
- Molina Healthcare (Akron, OH)
- …combination of education and experience **Preferred Experience** 7-9 years QNXT and/or Salesforce **Preferred License, Certification, Association** + Certification ... in Training and Development preferred for manager overseeing Training unit + Internal Audit Certification a plus for manager overseeing Regulatory Quality Audit unit To all current Molina employees: If you are interested in applying for this position, please… more
- Molina Healthcare (Cincinnati, OH)
- …special projects as assigned. + Other duties as assigned. Knowledgeable in systems utilized: + QNXT + Pega + Verint + Kronos + Microsoft Teams + Video Conferencing + ... Others as required by line of business or state **Job Function** Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating… more
- Molina Healthcare (OH)
- …in Medicaid, Medicare, and Marketplace lines of business. + Familiarity with QNXT claims processing platform. + Knowledge of legal procedures related to complex ... or litigated subrogation cases. Pay Range: $77,969 - $155,508 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. more
- Molina Healthcare (Dayton, OH)
- …and templates and ensures that all negotiated contracts can be configured in the QNXT system. Works with Legal and Corporate as needed to modify templates to ensure ... compliance with all contractual and/or regulatory requirements. + Oversees plan-specific fee schedule management. + Develops strategies to improve EDI/MASS rates. + Provides oversight of Provider Services and coordinates activities with Provider Association(s)… more