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Care Manager, LTSS

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
Madison, WI
***Remote with travel throughout Dane County for member visits*** JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. 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 of 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. • 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. • Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Problem-solving 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), 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. #PJHS #LI-AC1 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.
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Care Manager, LTSS (RN)

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
Beaver Dam, WI
***Remote with travel throughout Dodge, Fond du Lac, & Green Lake Counties, WI for member visits*** JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. 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. • 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 of experience in health care, including at least 1 year 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. • Registered Nurse (RN). 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. • Ability to operate proactively and demonstrate detail-oriented work. • Demonstrated knowledge of community resources. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations. • Ability to work independently, with minimal supervision and demonstrate self-motivation. • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Problem-solving skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. • 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.
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Care Manager, LTSS - Field travel in Racine and Kenosha County, WI

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
Racine, WI
JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. 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 of 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. • 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. • Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Problem-solving 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. #PJHS #LI-AC1 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.
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Care Manager, LTSS (RN)

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
Madison, WI
***Remote with travel throughout Dane County, WI for member visits*** JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. 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. • 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 of experience in health care, including at least 1 year 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. • Registered Nurse (RN). 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. • Ability to operate proactively and demonstrate detail-oriented work. • Demonstrated knowledge of community resources. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations. • Ability to work independently, with minimal supervision and demonstrate self-motivation. • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Problem-solving skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. • 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. #PJHS #LI-AC1 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.
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Examiner, Claims (must reside in Florida)

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
Florida
JOB DESCRIPTION Job Summary Provides support for claims examination activities including evaluation of adjudication of claims to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors. Essential Job Duties • Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and claims processing errors. • Manages a caseload of claims - procures all medical records and statements that support the claim. • Makes recommendations for further investigation and/or resolution of claims. • Reduces defects through proactive identification of error issues as it relates to pre-payment of claims through adjudication/trend identification, and recommends solutions to resolve issues. • Meets claims department quality and production standards. • Supports claims department initiatives to improve overall claims function efficiency. • Completes basic claims projects as assigned. Required Qualifications • At least 1 year of experience in a clerical role in a claims, and/or customer service setting - preferably in managed care, or equivalent combination of relevant education and experience. • Data entry and research skills. • Organizational skills and attention to detail. • Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. • Customer service experience. • Effective verbal and written communication skills. • Microsoft Office suite and applicable software programs proficiency. Preferred Qualifications • Health care claims/billing experience. • Medicaid claim processing experience is a plus. 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: $14 - $26.42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Product Owner (Custom Solutions/Custom Claim Processing)

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
Job Description Lead enterprise claim processing Custom Solutions product strategy by setting direction and priorities, governing requirements and solution design, and aligning stakeholders on regulatory, operational, and business outcomes. Own lifecycle decisions from BRD approval through testing, release, production risk, traceability to guide deployment, decommissioning and core-system transitions. Preferred Skills: QNXT Knowledge Claim Processing/Claim Lifecycle Knowledge Intermediate Reporting/Data Mining Job Summary Provides subject matter expertise in the delivery, execution and maintenance of products. Accountable for maximizing the value of assigned technical products that support enterprise operations. Owns the product vision, backlog, and delivery outcomes and serves as the primary bridge between business stakeholders and technical delivery teams. Defines what is built and why, ensuring solutions align to business outcomes, regulatory requirements, and enterprise strategy, while partnering closely with engineering, architecture, data, QA, and operations teams on how solutions are delivered. Maintains ownership of products across the full lifecycle—from discovery and intake through implementation, stabilization, optimization, and eventual retirement. Job Duties Owns and communicates a clear product vision aligned to enterprise strategy and operational outcomes. Maximizes product value by continuously prioritizing work based on business impact, regulatory requirements, risk, dependencies, and sustainability. Acts as the single point of accountability for product decisions, tradeoffs, and acceptance of delivered work. Serves as the primary escalation point for scope, priority, and requirement decisions. Owns the end‑to‑end product lifecycle, including enhancements, defect prioritization, technical debt, and modernization efforts. Creates, refines, and maintains a prioritized product backlog reflecting stakeholder needs and technical realities. Writes and maintains high‑quality epics, features, and user stories with clear acceptance criteria. Leads backlog refinement and actively participates in Agile ceremonies (planning, reviews, retrospectives). Accepts or rejects completed work based on defined acceptance criteria, quality standards, and regulatory alignment. Partners with business stakeholders to understand problems, desired outcomes, constraints, and regulatory obligations. Collaborates closely with engineering, architecture, data, QA, operations teams, and Health Plans to ensure solutions are feasible, scalable, and supportable. Translates complex technical concepts into business‑understandable terms and business needs into actionable technical requirements. Understands and supports leadership escalation protocols. Ensures product delivery aligns with security, regulatory, audit, and compliance requirements. Partners with health plan, compliance, legal, and audit teams as needed to support reviews and implementations. Ensures product documentation, controls, and artifacts remain current, accurate, and audit‑ready. Proactively identifies delivery risks and works with teams to mitigate impacts. Monitors product performance, usage, and outcomes; uses data and feedback to inform backlog priorities. Identifies opportunities for automation, optimization, and simplification of solutions. Supports enterprise goals related to standardization and reduction of unmanaged complexity. Owns one or more defined products or product areas with moderate complexity. Works under established product strategy, governance, and prioritization frameworks. Partners closely with stakeholders to clarify requirements and translate needs into backlog items. Manages competing priorities within a defined scope and escalates complex tradeoffs as needed. Demonstrates growing autonomy in backlog management, delivery decisions, and stakeholder engagement. Job Qualifications REQUIRED QUALIFICATIONS: At least 5 years of experience in product ownership, product management, business analysis, or technical solution delivery. Demonstrated experience working within Agile/Scrum delivery models. Experience supporting technical products such as enterprise platforms, configuration tools, data solutions, integrations, or operational systems. Strong understanding of software development lifecycles and Agile principles. Proven ability to write clear, testable user stories and acceptance criteria. Experience prioritizing work in complex, highly regulated environments. Strong analytical and problem‑solving skills. Excellent communication skills with the ability to influence across technical and non‑technical audiences. Ability to operate effectively in ambiguity and make decisions with incomplete information. PREFERRED QUALIFICATIONS: Prior Product Owner or Product Manager certification strongly preferred at time of hire. Experience with enterprise platforms, APIs, integrations, or configuration‑heavy systems. Experience in healthcare, financial services, or other regulated industries. Familiarity with Agile tooling (e.g., Jira, Azure DevOps, Rally). 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: $65,791 - $142,548 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Registered Dietitian - PST/MST Time Zones Preferred

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
Focus on Nutrition, Weight Management, Diabetes, HTN, and Heart Failure Job Summary Provides support for member disease specific nutritional needs. Contributes to interdisciplinary efforts supporting provision of integrated delivery of care across the continuum, and overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Provides diagnosis related therapeutic dietary education to members. • Consults with members, member families, physicians, and multidisciplinary team on member dietary planning needs. • Creates member specific dietary plans in accordance with individual care plans. • Develops and monitors parameters to measure member dietary care plan success. • Provides members with educational resources and on-going coaching to meet self-management goals. • Evaluates, interprets, monitors and documents member nutritional status and progress. Required Qualifications • At least 2 years of experience as a registered dietician, preferably in an outpatient, or in home setting, or equivalent combination of relevant education and experience. • Registered Dietician (RD). License must be active and unrestricted in state of practice. • Previous experience working with a multidisciplinary team. • Experience working with culturally diverse and low-income populations. • Excellent verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Managed care 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 Pay Range: $19.64 - $42.55 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Senior ServiceNow Engineer – AI Enablement & Platform Strategy - Remote

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
JOB DESCRIPTION Job Summary Provides senior level engineering support for enterprise infrastructure systems through contributions to the implementation, maintenance, and reliability of platforms that enable critical business services across compute, storage, networking, cloud, and automation technologies. Collaborates with engineers, architects, and cross-functional teams to drive system design, deployment, and operations throughout the technology lifecycle. Leverages infrastructure and security expertise to troubleshoot complex issues, optimize performance, and ensure solutions meet evolving business and technical requirements. Essential Job Duties • Supports and enhances enterprise information systems (EIS) and infrastructure technologies across compute, storage, networking, database, and hybrid cloud environments, including Azure services and automation. • Serves as a senior technical specialist for infrastructure platforms, systems technologies, cloud services, and automation frameworks. • Provides advanced scripting and automation support using PowerShell, Python, and infrastructure‑as‑code tools (such as Terraform) to improve efficiency, consistency, and scalability. • Builds strong relationships with IT leadership, engineers, program managers, support leads, and external vendors to understand requirements and deliver technical solutions. • Contributes to strategic planning of architecture standards, roadmaps, budgets, programs, and projects, and provides senior‑level technical input. • Facilitates and reviews technical design solutions, documentation requirements, and engineering standards across department functions. • Leads and executes complex build, deployment, and configuration activities across infrastructure platforms. • Ensures IT system implementations align with licensing, design, security, and compliance requirements, and provides guidance to engineering teams. • Supports and enhances monitoring, alerting, and observability tools (e.g., Splunk, Dynatrace, SolarWinds) to maintain system health, performance, and resiliency. • Supports security controls, patching, vulnerability remediation, and compliance requirements (HIPAA, HITECH), and provides technical guidance on remediation strategies. • Collaborates with networking, security, and application teams to ensure integrated, end‑to‑end service delivery and cross‑platform alignment. • Follows and reinforces project methodologies and change‑management processes to ensure compliant and consistent delivery. • Contributes to solution‑architecture delivery within project methodologies, timelines, and governance frameworks, and provides senior‑level technical recommendations. • Performs advanced root‑cause analysis, troubleshooting, and problem‑solving to resolve complex infrastructure and service issues and address IT‑related business challenges. • Leads or contributes to cross‑team project tasks, engineering deliverables, and technical workstreams. • Develops and presents technical solutions, engineering recommendations, and design considerations for peer‑review committees. • Shares technical concepts, best practices, and solutions with technical peer audiences and mentors junior engineers. • Participates in on‑call rotation schedules and off‑hours support activities, including escalation support for complex issues. • Ensures adherence to IT process controls, including incident, change, and configuration management, and contributes to process improvements. • Provides training and support to new and existing EIS team members, and constructive feedback to improve people, processes, and technology across the organization. Required Qualifications • At least 5 years of information technology (IT) engineering or infrastructure support experience, or an equivalent combination of relevant education and experience. • Bachelor's degree in IT, computer science, statistics, business, health care, engineering, etc. • Understanding of IT architecture concepts, enterprise infrastructure components, and the software development lifecycle (SDLC). • Experience working with enterprise information systems (IS), platforms, or infrastructure technologies. • Knowledge of health care payer processes/industry/trends and related regulatory requirements. • Ability to execute data queries and analysis to support troubleshooting and fact-based decision-making. • Analytical (including data analysis), critical‑thinking, and problem‑solving skills. • Planning and process design/improvement experience. • Effective organizational and time-management skills. • Ability and initiative to learn new technologies quickly, including cloud, automation, and monitoring tools. • Project management experience. • Ability to collaborate cross-functionally in a highly matrixed organization, and influence stakeholders on scalable solutions. • Exposure to hybrid cloud environments (Azure), scripting (PowerShell/Python), or infrastructure‑as‑code tools (Terraform). • Familiarity with monitoring/observability tools (Splunk, Dynatrace, SolarWinds) and basic security practices such as patching or vulnerability remediation. • Effective verbal/written/interpersonal communication skills. • Microsoft technology stack (including advanced Excel), and SQL proficiency. Preferred Qualifications • Managed care experience, including knowledge of health care payer systems, standards, and protocols. • Understanding of health care industry regulations and compliance requirements (e.g., HIPAA, HITECH). • Experience with Azure Cloud (or other cloud platforms), virtualization technologies, Windows/Linux systems, enterprise networking concepts, and enterprise platforms such as PEGA and Salesforce. • Proficiency with PowerShell, Python, and Terraform for automation and infrastructure design. • Experience contributing to architecture reviews, engineering standards, or modernization initiatives. 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: $79,607.91 - $172,483.8 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Manager, Regional Delegation Oversight

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
***Remote and must live in the United States*** JOB DESCRIPTION Job Summary Leads and manages a regional team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements. Collaborates closely with internal business owners to manage and administer the relationships and performance of delegated entities including health plan onboarding and offboarding activities, management of oversight activities, audits and corrective action plans, issuance and service issue escalations, and ongoing risk monitoring. Essential Job Duties • Oversees and manages the day-to-day operations of the delegation oversight program for assigned states and respective state delegates within a designated region. • Chairs monthly meetings of region and/or state (where contractually required with the state regulator) delegation oversight committee, including review of agendas and meeting minutes, and documents for committee oversight of delegated functions. • Coordinates, evaluates, and reviews delegation audit assessment tools as necessary to comply with state, federal, National Committee for Quality Assurance (NCQA), and any other applicable requirements. • Manages department processes, monitors performance of delegated entities on regulars intervals, and assigns corrective action plans (CAPs) when deficiencies are identified. • Prepares delegation oversight document evidence for state regulatory audits. • Collaborates with national delegation oversight senior leadership in the development of new and updates to existing delegation audit tools and policies/procedures. • Prepares delegation oversight performance reports for presentation to health plans and senior leadership. • Hires, trains, mentors, develops, and manages delegation oversight team, and demonstrates accountability for team performance. Required Qualifications • At least 7 years of related auditing/vendor/data management experience, preferably in delegation oversight, or equivalent combination of relevant education and experience. • At least 1 year management/leadership experience. • Ability to build relationships and manage a team. • Strong critical-thinking and problem-solving/analytical abilities. • Strong time-management, organizational, detail orientation and prioritization skills. • Strong project management skills and knowledge of project management tools/processes. • Strong data processing/analysis experience. • Ability to interpret error reports and identify remediation steps. • Ability to collaborate cross-functionally across a highly matrixed organization. • Strong interpersonal and verbal/written communication skills. • Microsoft Office suite proficiency (including Excel), and ability to learn/navigate new software programs. Preferred Qualifications • Delegation oversight experience. #PJHPO #LI-AC1 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: $72,370.82 - $156,803.45 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Care Management Processor (must reside in WI)

Molina Healthcare - Sep 27, 2026
Location-based
Full-time
Salary
Milwaukee, WI
JOB DESCRIPTION Job SummaryProvides non-clinical administrative support to the care management function, and contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Facilitates administrative support including case assignment, member screening and scheduling, correspondence processing, data entry and telephone and clerical support for team facilitating care management related services for members. • Facilitates initial review of assigned case levels and assists in case management assignment to care managers. • Reviews data to identify principle member needs and works under the direction of the care manager to implement care plan. • Schedules member visits with care managers as needed. • Screens members according to Molina policies and processes and assists care management staff during process of identifying appropriate member services. • Coordinates required member services in accordance with member benefit plan. • Promotes communication both internally and externally to enhance effectiveness of care management services. • Processes member and provider correspondence. Required Qualifications• At least 1 year of experience in an administrative support role in health care, or equivalent combination of relevant education and experience. • Strong attention to detail. • Problem-solving skills. • Working knowledge of Microsoft Office (Outlook, Word, Excel) or other comparable software. • Excellent customer service skills. • Time-management and organizational skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Certified Medical Assistant (CMA). 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: $14.9 - $29.06 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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