• Manager , Healthcare Services;…

    Molina Healthcare (GA)
    …services and supports (LTSS), and/or member assessment. * Facilitates integrated, proactive healthcare services management - ensuring compliance with state and ... This position will offer remote work flexibility, however, the selected candidate must...DESCRIPTION Job Summary Leads and manages multidisciplinary team of healthcare services professionals in some or all of the… more
    Molina Healthcare (09/20/25)
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  • Manager Integrated Case Mgmt-SCMG…

    Sharp HealthCare (San Diego, CA)
    …Certified Professional in Healthcare Quality (CPHQ) - National Association for Healthcare Quality; Certified Case Manager (CCM) - Commission for Case ... and HS leadership team to ensure regulatory and legislative compliance for the division. Under the direction of the... Healthcare Quality (CPHQ) - National Association for Healthcare Quality -PREFERRED + Certified Case Manager more
    Sharp HealthCare (08/29/25)
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  • Temporary Clinical Compliance

    Prolink (Cincinnati, OH)
    Temporary Clinical Compliance Manager (2025-3186) job in Remote **Location:** Remote **Role Type:** Compliance **JOB SUMMARY** The Clinical ... to lead and engage a high performing team of compliance professionals. This is a temporary position covering a...state(s) * Experience in a supervisory capacity and various healthcare settings * Experience with leadership in clinical regulatory… more
    Prolink (10/25/25)
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  • Post Acute Network Program Manager

    Molina Healthcare (Sterling Heights, MI)
    Molina Healthcare is hiring for a Post Acute Network Program Manager in Michigan **.** This role is remote with up to 25% statewide travel. Molina ... Healthcare is seeking a Post Acute Network Program Manager to join our Population Health team! In this role, you'll work closely with **skilled nursing and… more
    Molina Healthcare (10/23/25)
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  • Out of Network (OON) Clinical Case Manager

    Sharp HealthCare (San Diego, CA)
    …Variable **FTE** 0 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered ... Nursing; Driver's License - CA Department of Motor Vehicles; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Master's Degree in Nursing;… more
    Sharp HealthCare (10/25/25)
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  • Case Manager I - Scmg Integrated Care Mgmnt…

    Sharp HealthCare (San Diego, CA)
    …**Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered ... as defined by the collective bargaining agreement between Sharp HealthCare and Sharp Professional Nurses Network, United Nurses Associations...or equivalent degree. + Master's Degree + Certified Case Manager (CCM) - Commission for Case Manager more
    Sharp HealthCare (10/19/25)
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  • Senior Specialist, Quality Interventions/QI…

    Molina Healthcare (Chicago, IL)
    …Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Interventions /… more
    Molina Healthcare (10/18/25)
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  • Provider Contracts Manager - Complex…

    Molina Healthcare (Boise, ID)
    …to adequacy, financial performance and operational performance, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in ... compliance with all relevant federal, state and local regulations....knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts including but… more
    Molina Healthcare (10/18/25)
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  • Provider Engagement Manager ( Remote

    Molina Healthcare (New York, NY)
    …problem resolution for the Provider Engagement team. Communicates effectively with healthcare professionals and maintains compliance with policies. **Job ... **Job Description** **Job Summary** The Provider Engagement Manager implements Health Plan provider engagement strategy to...assigned provider practices. * Maintains the highest level of compliance . * This position may require same day out… more
    Molina Healthcare (09/25/25)
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  • Risk & Quality Performance Manager

    Molina Healthcare (Dallas, TX)
    **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... and make decisions as needed while collaborating with other teams. * Ensure compliance with all regulatory audit guidelines by adhering to roadmap of deliverables… more
    Molina Healthcare (10/18/25)
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