Employment Opportunities
Contact Janet Jabrani, Human Resources Manager, at
(314) 432-9204 or send an email for
additional information.
Download a copy of our employment application here.
Quality Improvement Analyst for its Creve Coeur, Missouri location
This is the opportunity for you to join one of Missouri's most respected managed health care organizations.
Mercy CarePlus (MCP), a Molina Healthcare Company, is seeking a Quality Improvement Analyst for its Creve Coeur, Missouri location.
Qualifications
- Registered Nurse or Registered Health Information Administrator
- Experience in Quality Improvement methodology
- Experience with NCQA accreditation and HEDIS reporting
- Experience in a managed care setting
- Project management skills including the ability to prioritize multiple tasks and problem solve
- Working knowledge of computer software programs such as Word, Excel, and Access
- Excellent interpersonal and communication skills (verbal and written)
Principal Responsibilities
- Conducts quality review audits
- Collects and analyzes data for relevant quality improvement indicators through medical record audits and other tools/documentation
- Ensures the effectiveness of data collection and evaluation processes by reviewing and analyzing input, processing and data output activities
- Prepares reports and analyses setting forth improvement, adverse trends and appropriate recommendations and conclusions
- Implements Quality Improvement activities related to quality initiatives
- Collects and monitors EPSDT data
- Collects, monitors and evaluates data for Performance Improvement Projects (PIPs)
- Assists in preparation of External Quality Review Organization (EQRO) audit
- Maintains medical information pertaining to clinical practice and guidelines in accordance with HIPAA regulations
- Other projects and responsibilities as assigned
Description of Position
- Performs audits of medical records to demonstrate compliance with contractual obligations and identify opportunities for improvement
- Performs audits of medical records to validate medical record-keeping practices for credentialing and recredentialing purposes
- Coordinates the collection, evaluation and dissemination of quality improvement data and audits
- Plans and coordinates quality improvement monitoring and activities
- Participates in NCQA accreditation preparedness and maintenance activities
- Designs and implements a strategic plan for monitoring and increasing the plan’s EPSDT rates
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Community Outreach Representative for its Kansas City, Missouri location
This is the opportunity for you to join one of Missouri's most respected managed health care organizations.
Mercy CarePlus (MCP), a Molina Healthcare Company, is seeking a Community Outreach Representative. The Community Outreach Representative will be based out of the Kansas City, Missouri location.
Qualifications
- 3+ years experience in managed care organization
- Self-directed with the ability to work under pressure with little or minimal supervision
- Working knowledge of managed care and HMO experience
- Above average written and verbal communications skills
- Ability to deliver formal presentations
- Ability to accomplish multiple tasks and prioritizes time efficiently
- Aggressive and outgoing personality
- Flexible working schedules, including some late evenings and weekends
- Ability to assess market for additional marketing activities for Mercy CarePlus Representatives
Principal Responsibilities
The primary objective of this position is managing all outreach and administrative support for Mercy CarePlus’ school based program. Additional responsibilities include marketing to and for new members for Mercy CarePlus through community health fairs, special events, birthday parties, recreational centers, schools, annual parades and all additional organized events which may attract Medicaid members through direct or indirect contact with a Mercy CarePlus representative.
All duties of this position will be performed according to established policies, procedures, and methods within the department and the Company. These examples of work are not all encompassing and are expected to vary with the changing needs and priorities of the Company.
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Community Outreach Representative for its Jefferson City, Missouri location
This is the opportunity for you to join one of Missouri's most respected managed health care organizations.
Mercy CarePlus (MCP), a Molina Healthcare Company, is seeking a Community Outreach Representative. The Community Outreach Representative will be based out of the Jefferson City, Missouri location.
Qualifications
- 3+ years experience in managed care organization
- Self-directed with the ability to work under pressure with little or minimal supervision
- Working knowledge of managed care and HMO experience
- Above average written and verbal communications skills
- Ability to deliver formal presentations
- Ability to accomplish multiple tasks and prioritizes time efficiently
- Aggressive and outgoing personality
- Flexible working schedules, including some late evenings and weekends
- Ability to assess market for additional marketing activities for Mercy CarePlus Representatives
Principal Responsibilities
The primary objective of this position is managing all outreach and administrative support for Mercy CarePlus’ school based program. Additional responsibilities include marketing to and for new members for Mercy CarePlus through community health fairs, special events, birthday parties, recreational centers, schools, annual parades and all additional organized events which may attract Medicaid members through direct or indirect contact with a Mercy CarePlus representative.
All duties of this position will be performed according to established policies, procedures, and methods within the department and the Company. These examples of work are not all encompassing and are expected to vary with the changing needs and priorities of the Company.
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Clinical Case Manager I for its Creve Coeur, Missouri location
This is the opportunity for you to join one of Missouri's most respected managed health care organizations.
Mercy CarePlus (MCP), a Molina Healthcare Company, is seeking a Clinical Case Manager I for its Creve Coeur, Missouri location.
Qualifications
- Bachelor’s degree in Healthcare Administration or other health related field
- Registered Health Information Administrator, Registered Nurse or Licensed Practical Nurse
- Experience in Quality Improvement methodology
- Experience in a managed care setting
- Project management skills including the ability to prioritize multiple tasks
- Ability to problem solve and follow through on resolution
- Working knowledge of computer software programs such as Word, Excel, and Access
- Excellent interpersonal and communication skills (verbal and written)
- Ability to travel
Principal Responsibilities
- Conducts quality review audits
- Collects and analyzes data for relevant quality improvement indicators through medical record audits and other tools/documentation
- Ensures the effectiveness of data collection and evaluation processes by reviewing and analyzing input, processing and data output activities
- Prepares reports and analyses setting forth improvement, adverse trends and appropriate recommendations and conclusions
- Implements Quality Improvement activities related to quality initiatives
- Collects and monitors EPSDT data
- Collects, monitors and evaluates data for Performance Improvement Projects (PIPs)
- Assists in preparation of External Quality Review Organization (EQRO) audit
- Maintains medical information pertaining to clinical practice and guidelines in accordance with HIPAA regulations
- Other projects and responsibilities as assigned
Description of Position
- Performs audits of medical records to demonstrate compliance with contractual obligations and identify opportunities for improvement
- Performs audits of medical records to validate medical record-keeping practices for credentialing/recredentialing purposes
- Coordinates the collection, evaluation and dissemination of quality improvement data and audits
- Plans and coordinates quality improvement monitoring and activities
- Designs and implements a strategic plan for monitoring and increasing the plan’s EPSDT rates
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Utilization Review Specialist I for its Creve Coeur, Missouri location
This is the opportunity for you to join one of Missouri's most respected managed health care organizations.
Mercy CarePlus, a Molina Healthcare Company, is seeking a Utilization Review Specialist I for its Creve Coeur, Missouri location. This Licensed Practical Nurse would Apply InterQual Criteria to ensure medical necessity is met for authorization of elective surgeries, procedures, tests and all services requiring authorizations including pharmacy.
Qualifications
- Licensed Practical Nurse with current Missouri license
- One year managed care experience preferred
- Ability to articulate clearly and concisely in a professional and friendly manner
- Typing/Data entry skills
- Familiarity with word processing and spreadsheet software
- Ability to accomplish multiple tasks and prioritize in a timely and efficient manner
- Self directed with the ability to work under pressure with little or minimal supervision
- Medical terminology
Principal Responsibilities
- Issues authorizations for appropriate services from telephonic or faxed requests and maintains files for referrals and ancillary services
- Communicates with providers and educates on policies and procedures pertaining to referrals, pharmacy and the authorization process
- Discusses appropriate cases with the Chief Medical Officer or Director of Medical Services
- Maintains current knowledge of benefits and contracts and exclusions
- Supports Quality Improvement activities by identifying quality issues and reporting to appropriate personnel
- Authorizes non-formulary medications approved by Chief Medical Officer
- Other duties as assigned
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All positions will require the successful completion of a background check and drug screening.
As a Mercy CarePlus employee, you'll enjoy an excellent benefits package that includes medical, dental, vision, life insurance and disability plans for a contributory rate. Mercy CarePlus also offers a flexible spending account, company-paid holidays and a Company sponsored 401(k) savings plan.
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