RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
Long Beach, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
Long Beach, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
Long Beach, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
Sacramento, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
Sacramento, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
San Jose, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
San Jose, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
San Diego, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
San Diego, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
Los Angeles, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
Los Angeles, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
San Francisco, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
San Francisco, CA · Remote
$30.37 - $59.21/hr
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient ... Employment Type: Full Time
... MDs/DOs) to join our virtual clinical team. In this role, you'll lead life-changing treatment ... This role will be remote anywhere in the US. Key Responsibilities: * Conduct 1:1 video ...
Quick apply
... MDs/DOs) to join our virtual clinical team. In this role, you'll lead life-changing treatment ... This role will be remote anywhere in the US. Key Responsibilities: * Conduct 1:1 video ...
Houston, TX · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Quick apply
Houston, TX · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Jacksonville, FL · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Quick apply
Jacksonville, FL · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Atlanta, GA · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Quick apply
Atlanta, GA · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Baltimore, MD · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Quick apply
Baltimore, MD · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
New York, NY · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Quick apply
New York, NY · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Philadelphia, PA · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
New
Quick apply
Philadelphia, PA · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
New
Chicago, IL · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Quick apply
Chicago, IL · Remote
$65K/yr
Fully remote within the U.S. Your Impact * Analyze intake assessments, including medical history ... Collaborate with APRNs and MDs involved in the medical management of your patients. * Maintain ...
Job Type Full-time Description Paylocity is an award-winning provider of cloud-based HR and payroll ... This is a fully remote position, allowing you to work from home or location of record within the U.
Job Type Full-time Description Paylocity is an award-winning provider of cloud-based HR and payroll ... This is a fully remote position, allowing you to work from home or location of record within the U.
$19.95 - $23.93
3% of jobs
$23.93 - $27.91
2% of jobs
$27.91 - $31.88
12% of jobs
$33.87 is the 25th percentile. Wages below this are outliers.
$31.88 - $35.86
16% of jobs
The median wage is $39.04 / hr.
$35.86 - $39.84
21% of jobs
$43.53 is the 75th percentile. Wages above this are outliers.
$39.84 - $43.82
22% of jobs
$43.82 - $47.79
7% of jobs
$47.79 - $51.77
7% of jobs
$51.77 - $55.75
5% of jobs
$55.75 - $59.72
2% of jobs
$59.72 - $63.70
1% of jobs
$19
$41
$63
| Aspect | Full Time Remote Mds | Full Time Remote Nurse Practitioners |
|---|---|---|
| Credentials | Medical Degree (MD), State Licensure | Nurse Practitioner Certification, State Licensure |
| Work Environment | Remote healthcare consulting, telemedicine | Remote patient care, telehealth services |
| Industry Usage | Hospitals, clinics, telemedicine companies | Primary care, specialty clinics, telehealth platforms |
Both Full Time Remote Mds and Nurse Practitioners work remotely in healthcare, but Mds typically have a medical degree and focus on diagnosis and treatment planning, while Nurse Practitioners are advanced practice nurses providing direct patient care. Their roles overlap in telehealth settings, but credentials and scope of practice differ.

Long Beach, CA • Remote
$30.37 - $59.21/hr
Full-time
Posted 12 days ago
8.0
Based on 192 frontline employees who took The Breakroom Quiz
146th of 261 rated insurance
JOB DESCRIPTION Job Summary
Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote the Molina care model.
Adheres to utilization management (UM) policies and procedures.
Required Qualifications
At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Strong written and verbal communication skills.
Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
Certified Professional in Healthcare Management (CPHM).
Utilization review, prior authorization, inpatient review desirable. MCG experience, strongly preferred.
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: $30.37 - $59.21 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Health care and social assistance
10,000+ Employees
Long Beach, CA, US
1980