Role Description Responsible for leveraging the technology for the benefit of the business. Interface and manage strategic relationships with business partners by representing & promoting IM capabilities. - Builds and maintains effective and trusting business relationships with both external and internal stakeholders such as health plan Senior Leadership/Senior Management and/or Corporate Executives, Molina Medical Solutions, other IT functions to understand their business needs, strategies, priorities and key issues. - Documents, manages and maintains state service level agreements for compliance deliverables for IT. - Works as a liaison between the business, Shared Services and IT to deliver key business initiatives, process improvements, manage service level agreements and business communications for their assigned line of business. - Provides knowledge of business processes, IT technologies and process to inform appropriate project triage. - Consults with the business (as well as collaboration with IT) on project scope, assumptions, development progress and estimation. - Manages/oversees cross-functional projects to completion for any non-PMO or Domain-led projects. - Utilizes standard communication protocols and forums to consistently provide updates and promotion of IT services/projects. - Translates business needs into IT work product and or project requests. - Assimilates and documents business needs project requests and benefit value documentation including high level IT requirements, compliance implications and cost benefit analysis. - Provides technical and process knowledge within IT across silos and business partners to support consulting, problem resolution/facilitation and effective intake and solutioning. - Coaches and brings resources to bear on project deliverables including BRD, RRD, PR, and CR. - Demonstrates Healthcare business process and/or functional knowledge. - Demonstrates use of effective communications and soft skills to build and maintain effective business relationships on behalf of IT. - Ability to manage high volume of Demand Intake requests from various Business partners across multiple domain areas. - Ability to identify high level deliverables for cost estimations and timelines. - Maintains management/technical skills that can be utilized in the field to solve complex problems. Qualifications - Bachelor's Degree or equivalent combination of education and experience. - 6 - 8 years experience in Managed care, IT system delivery or related experience. Requirements - Graduate Degree or equivalent combination of education and experience (preferred). - Six Sigma Black Belt, PMI - Project Management Professional, ITIL Certification (preferred). - 7-9 years experience in Managed care, IT system delivery or related experience (preferred). Benefits - Molina Healthcare offers a competitive benefits and compensation package. - Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Role Description The Complex Care Nurse Case Manager provides clinical oversight and medical-necessity support for complex workers’ compensation claims across MTI America’s ancillary service lines. This role reviews clinical information, collaborates with internal teams and external stakeholders, and helps ensure timely, appropriate, and cost-conscious care recommendations for injured workers. The ideal candidate brings strong clinical judgment, critical thinking, communication, and relationship-building skills. This position is well suited for an RN who can apply clinical experience in a non-direct-care environment, manage multiple priorities, and adapt to a specialized workers’ compensation and ancillary-services setting. Key Responsibilities - Provide clinical oversight and support for complex claims involving Home Health, Physical Medicine, Transportation, Language Services, Medical Care, Durable Medical Equipment, orthotics and prosthetics, respiratory equipment and supplies, medical supplies, and home or vehicle modifications. - Review medical records, physician orders, progress notes, claims information, and clinical documentation to assess medical necessity and appropriateness of requested services. - Apply clinical judgment, established medical criteria, and applicable state jurisdictional requirements when making medical-necessity recommendations. - Analyze inpatient level-of-care documentation and assist with clinical review of proposed, concurrent, or retrospective services. - Review CPT and HCPCS coding, charges, and potential up-coding concerns as part of claims and service review. - Audit medical-necessity claims, peer-review reports, correspondence, addendums, and supplemental reviews in accordance with departmental policies and procedures. - Obtain and organize clinical information needed to support authorization recommendations for nurse case managers, adjusters, and internal stakeholders. - Provide direct clinical oversight and management of Complex Care Acute, Complex Care, and Complex Care Specialty claims within the MTI 360 platform. - Partner with coordinators to monitor complex cases and provide periodic patient-status updates. - Serve as a key clinical liaison between Claims, Medical Services, Operations, clients, nurse case managers, providers, and other stakeholders. - Build and maintain collaborative relationships with physicians, nurses, nurse case managers, ancillary providers, adjusters, and clients. - Support client satisfaction through timely communication, thoughtful discharge-planning support, responsiveness, and clinically appropriate recommendations. - Support the Sales team as a clinical and complex-care subject-matter expert during client meetings, stewardship discussions, and prospective-client opportunities. - Create and deliver educational programs, including CEU content, for insurance carriers, TPAs, nurse case managers, adjusters, and other external audiences as needed. - Assist with the development and implementation of utilization-management and clinical-review programs, including the use of ODG guidelines where applicable. - Participate in business meetings, conferences, webinars, and other professional-development or client-facing activities as needed. - Learn and effectively use MTI systems, workflows, and documentation processes through onboarding and ongoing training. Qualifications - Active, unrestricted Registered Nurse (RN) license. - Bachelor’s Degree in Nursing. - Three to five years of nursing experience in a hospital, clinical, managed-care, utilization-review, case-management, or comparable healthcare setting. - Strong knowledge of medical terminology, diagnoses, clinical documentation, and physician orders. - Experience reviewing medical records, progress notes, and clinical information to support care decisions. - Demonstrated critical-thinking, clinical-judgment, problem-solving, and decision-making skills. - Strong written and verbal communication skills, including the ability to communicate clinical information clearly to both clinical and non-clinical audiences. - Ability to build effective working relationships with internal teams, clients, providers, nurse case managers, and other stakeholders. - Strong organizational skills and ability to manage multiple files, priorities, and turnaround-time expectations. - Ability to work independently in a remote environment while remaining responsive and collaborative. - Comfort learning new systems, processes, and a specialized workers’ compensation environment. - Proficiency with Microsoft Office, including Word, Excel, and Outlook. - Ability to comply with company policies, HIPAA requirements, and applicable state and federal regulations. Preferred Qualifications - Certified Case Manager (CCM) credential or progress toward certification. - Workers’ compensation experience. - Experience supporting ancillary services, including Home Health, Durable Medical Equipment, home or vehicle modifications, respiratory equipment, orthotics and prosthetics, or related services. - Utilization-review, utilization-management, or formal case-management experience. - Active bedside or direct-patient-care nursing experience. - Experience with discharge planning, care coordination, inpatient review, or complex-care management. - Experience auditing claims, clinical documentation, medical-necessity determinations, or coding-related concerns. - Experience presenting, participating in webinars, or delivering clinical education to external audiences. - Experience working with ODG guidelines or similar evidence-based clinical-review criteria. Core Competencies - Clinical judgment and critical thinking - Problem solving and sound decision-making - Written and verbal communication - Relationship building and stakeholder management - Responsiveness and follow-through - Organization and file management - Adaptability and willingness to learn - Client-service mindset - Ability to work effectively in a specialized, non-emergent clinical environment Schedule & Availability - Core business hours are generally 8:00 a.m. to 5:00 p.m. Eastern Time, with flexibility based on business needs. - This role is not routinely on call; however, occasional after-hours availability may be needed to support urgent business or client needs. - This position involves regular communication by phone, email, and virtual meetings. - Approximately 25% to 30% of the role may involve phone-based communication with clients, providers, nurse case managers, adjusters, and internal partners. Work Environment & Physical Requirements - Remote office environment. - May require occasional travel for client meetings, conferences, or business needs. - Ability to sit or stand for extended periods. - Ability to communicate effectively by phone, video conference, email, and other virtual communication tools. - Ability to lift up to 5 pounds, if applicable. Compensation & Benefits - Competitive salary based on experience. - Health, dental, and vision insurance. - 401(k) with company match. - Paid time off and holidays. Equal Opportunity Employer MTI America is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Role Description This is your chance to be part of a Corporate Human Resources team at a top global hospitality company! As a Manager, Learning Technology, you will partner with our business leaders to attract, retain, and develop Hilton's most important asset, our Team Members. On the HR Technology & Innovation Team reporting to the Director, HR Talent Technology, you will help drive the technical direction and evolution of Hilton's enterprise learning ecosystem. - Architect, maintain, and continuously optimize the LMS technical ecosystem, including inbound and outbound integrations, APIs, data flows, and system connectivity across enterprise platforms systems and external vendors. - Support platform governance for the LMS, leading configuration, technical vendor management, testing oversight, documentation standards, and reporting analytics to ensure scalable, compliant, and high-impact learning delivery globally. - Build and support REST‑based integrations, including authentication, JSON/XML workflows, and ongoing troubleshooting. - Develop and manage automated workflows using tools such as Microsoft Power Automate, Zapier, or Informatica. - Act as the escalation point for LMS issues across configuration, integrations, reporting, and platform analytics. - Support the greater Learning Technology team where needed with course content and system troubleshooting. Qualifications - Five (5) years of experience in learning technology role within a global or multi‑region environment. - Five plus (5+) years of experience with Cornerstone LMS, SumTotal, SuccessFactors or a similar learning management system. - Three (3) years of hands‑on experience supporting Learning Management Systems, including reporting, content management, and system operations. - Two (2) years of experience with importing information into a learning management system using mass upload tools, such as the Rapid Data Import tool in Cornerstone products. - API integration expertise, with hands‑on experience designing and supporting REST APIs, working with JSON and XML data formats, and implementing secure authentication protocols. - Understanding of LMS data structures, eLearning standards (SCORM, xAPI/AICC), compliance and audit reporting, and content lifecycle management. - Experience building and managing Microsoft Power Automate workflows or similar. Requirements - Bachelor's degree or higher. - Experience producing security‑focused technical documentation, including architecture and application data flow diagrams for security and compliance reviews. - Experience with additional Power Platform tools such as Power Apps and Power BI. - Familiarity with Oracle HCM Cloud integrations, ServiceNow, and identity management or SSO platforms. - Cornerstone certifications or relevant technical certifications (e.g., Microsoft Power Platform, API development). Benefits - Incredible travel perks – Enjoy 110 nights of deeply discounted travel, with room rates as low as $40/night at our world-class hotels through our Go Hilton travel program. - Own a piece of Hilton – Through our employee stock purchase program (ESPP), you can invest in Hilton shares at a 15% discount to help build your financial future. - Paid parental leave – Because family matters. We offer paid leave for eligible Team Members, including partners and adoptive parents. - Personalized caregiving support – Access dedicated caregiving concierge services to help navigate caregiving for yourself and your loved ones. - Crisis concierge – In times of loss, our Crisis Concierge offers a single, compassionate point of contact for both practical support and emotional care. - Mental health resources – Your wellbeing comes first. Eligible Team Members can access free counseling and support through our best-in-class Employee Assistance Program (EAP). - Generous paid time off (PTO) – Recharge, relax, and take time for what matters most. - Health & welfare benefits – From checkups to dental cleanings to new glasses, we offer a variety of health plans that keep you and your family covered. - Financial security for your future – Our retirement plans make it easier to save for what's next.

Role Description Leads and manages team responsible for special investigation unit (SIU) activities, specifically the prevention and detection of violation of applicable laws and regulations. Responsible to protect the business from liability of fraudulent or abusive practices, and ensure the business understands and complies with applicable laws and regulations pertaining to the health care environment. Accountable for oversight, follow-up and resolution of investigations. - Provides oversight and review of the special investigation unit (SIU) referral intake and investigation process, and provides guidance and direction to team on case investigation steps/actions. - Collaborates with leadership to maintain and revise policies and procedures, fraud, waste, and abuse (FWA) plans, annual audit work plans - including department guidance memos, and educational materials. - Identifies opportunities for improvement through the audit process and provides recommendations for system enhancements in order to augment investigative outcomes and performance. - Accurately tracks, reports, and follows-up on overpayments and recoveries. - Leads business requirement process and reporting to ensure proper and timely notification of case activity to the appropriate regulatory and/or law enforcement agency. Qualifications - At least 7 years of experience in special investigations, law enforcement, and/or experience in a regulatory environment, or equivalent combination of relevant education and experience. - At least 1 year of management/leadership experience. - Strong interpersonal skills. - Strong analytical and critical-thinking abilities. - Organizational and time-management skills. - Experience with investigative case management system. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Requirements - Health Care Anti-Fraud Associate (HCAFA), Accredited Health Care Fraud Investigator (AHFI) and/or Certified Fraud Examiner (CFE). Benefits Molina Healthcare offers a competitive benefits and compensation package. Company Description Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.