Teams at Molina Healthcare Inc.

Provides community-based member advocacy and non-clinical field support to help vulnerable members access health care, social services, and maintain Medicaid eligibility. Conducts outreach, home and community visits, schedules appointments, coordinates transportation, researches hard-to-reach members, and collaborates with health services teams to support member engagement and care navigation.

Manage and supervise a configuration oversight team performing claims audits, ensuring timely, compliant audits and corrective actions. Liaise with stakeholders, develop policies/procedures, identify and mitigate regulatory risks, produce reports, and lead performance improvement and training activities.

Conduct face-to-face eligibility screenings using the Wisconsin Adult LTC-FS for IRIS participants, complete annual and change-of-condition screens, verify information with providers and agencies, maintain documentation and certification, participate in trainings and team meetings, and perform related duties including timely, accurate data entry and limited travel to participant homes.