Lexington, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Lexington, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Paducah, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Paducah, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Louisville, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Louisville, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Owensboro, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Owensboro, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Covington, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Covington, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Owensboro, KY · Remote
$25.08 - $51.49/hr
... 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 ...
Owensboro, KY · Remote
$25.08 - $51.49/hr
... 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 ...
... registered nurses, advanced practice providers, and physicians in roles where they can make a ... Georgia Expansion planned for New York and Maine. If you have a proven background in healthcare ...
Quick apply
... registered nurses, advanced practice providers, and physicians in roles where they can make a ... Georgia Expansion planned for New York and Maine. If you have a proven background in healthcare ...
Louisville, KY · Remote
$28/hr
This role is great for anyone who loves meeting and assisting new patients daily. What's in it for ... Consistent schedule - Full-Time Monday - Friday, no weekends, rotational on-call-once per year on ...
Louisville, KY · Remote
$28/hr
This role is great for anyone who loves meeting and assisting new patients daily. What's in it for ... Consistent schedule - Full-Time Monday - Friday, no weekends, rotational on-call-once per year on ...
Louisville, KY · On-site +1
$28/hr
This role is great for anyone who loves meeting and assisting new patients daily. What's in it for ... Consistent schedule - Full-Time Monday - Friday, no weekends, rotational on-call-once per year on ...
Louisville, KY · On-site +1
$28/hr
This role is great for anyone who loves meeting and assisting new patients daily. What's in it for ... Consistent schedule - Full-Time Monday - Friday, no weekends, rotational on-call-once per year on ...
Louisville, KY · Remote
$76K - $149K/yr
Registered Nurse (RN) or Advanced Practice Social Worker (APSW), or Licensed Behavioral Health ... Employment Type: Full Time
Louisville, KY · Remote
$76K - $149K/yr
Registered Nurse (RN) or Advanced Practice Social Worker (APSW), or Licensed Behavioral Health ... Employment Type: Full Time
Ashland, KY · On-site +1
$13.50 - $17.75/hr
Certifications & Licensures Kentucky State Registered Nurse Assistance (SRNA) certificate Working ... Days (United States of America) Time Type : Full time Address : 2500 State Rt 5 City, State
Ashland, KY · On-site +1
$13.50 - $17.75/hr
Certifications & Licensures Kentucky State Registered Nurse Assistance (SRNA) certificate Working ... Days (United States of America) Time Type : Full time Address : 2500 State Rt 5 City, State
Ashland, KY · On-site +1
$13.50 - $17.75/hr
Certifications & Licensures Kentucky State Registered Nurse Assistance (SRNA) certificate Working ... Days (United States of America) Time Type : Full time Address : 2500 State Rt 5 City, State
Ashland, KY · On-site +1
$13.50 - $17.75/hr
Certifications & Licensures Kentucky State Registered Nurse Assistance (SRNA) certificate Working ... Days (United States of America) Time Type : Full time Address : 2500 State Rt 5 City, State
New increased hourly compensation : insurance sessions now pay 40% - 57% more in select states ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Quick apply
New increased hourly compensation : insurance sessions now pay 40% - 57% more in select states ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Louisville, KY · On-site +1
Remote NY will be considered, preferred is DC Metro and Louisville, KY. Travel : Occasional travel ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...
Louisville, KY · On-site +1
Remote NY will be considered, preferred is DC Metro and Louisville, KY. Travel : Occasional travel ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...
New increased hourly compensation : insurance sessions now pay 40% - 57% more in select states ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Quick apply
New increased hourly compensation : insurance sessions now pay 40% - 57% more in select states ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Louisville, KY · On-site +1
Remote NY will be considered, preferred is DC Metro and Louisville, KY. Travel : Occasional travel ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...
Louisville, KY · On-site +1
Remote NY will be considered, preferred is DC Metro and Louisville, KY. Travel : Occasional travel ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...
Ashland, KY · On-site +1
Job Summary Responsible for utilizing remote patient safety audio and video monitoring technology ... Certifications & Licensures State Registered Nurses Aid (SRNA) certification in applicable state ...
Ashland, KY · On-site +1
Job Summary Responsible for utilizing remote patient safety audio and video monitoring technology ... Certifications & Licensures State Registered Nurses Aid (SRNA) certification in applicable state ...
Ashland, KY · On-site +1
Job Summary Responsible for utilizing remote patient safety audio and video monitoring technology ... Certifications & Licensures State Registered Nurses Aid (SRNA) certification in applicable state ...
Ashland, KY · On-site +1
Job Summary Responsible for utilizing remote patient safety audio and video monitoring technology ... Certifications & Licensures State Registered Nurses Aid (SRNA) certification in applicable state ...
Louisville, KY · On-site +1
$23.50 - $32/hr
Location - Remote Schedule - Fulltime Day Shift 7a-7p Your experience matters Lifepoint Health is a ... As a Behavioral Health Transfer Center LPN joining our team, you're embracing a vital mission ...
Louisville, KY · On-site +1
$23.50 - $32/hr
Location - Remote Schedule - Fulltime Day Shift 7a-7p Your experience matters Lifepoint Health is a ... As a Behavioral Health Transfer Center LPN joining our team, you're embracing a vital mission ...
Louisville, KY · Remote
$24.75 - $33.50/hr
Location - Remote Schedule - Fulltime Various Shifts 7p-7a or 7a-7p Your experience matters ... As a Behavioral Health Transfer Center LPN joining our team, you're embracing a vital mission ...
Louisville, KY · Remote
$24.75 - $33.50/hr
Location - Remote Schedule - Fulltime Various Shifts 7p-7a or 7a-7p Your experience matters ... As a Behavioral Health Transfer Center LPN joining our team, you're embracing a vital mission ...
| Aspect | Full Time Remote New Grad Rn | Full Time Remote Registered Nurse |
|---|---|---|
| Credentials | State RN license, new graduate certification | State RN license, experience preferred |
| Work Environment | Remote, healthcare setting, supervised training | Remote, healthcare setting, more autonomous |
| Employer & Industry | Hospitals, clinics, telehealth companies | Hospitals, telehealth, insurance companies |
| Search & Comparison Intent | Entry-level, recent grads, remote nursing jobs | Experienced nurses seeking remote roles |
The main difference is experience level and expectations. Full Time Remote New Grad Rn roles are designed for recent graduates with less experience, focusing on training and supervision. Full Time Remote Registered Nurse positions typically require prior experience and offer more autonomy. Both roles are remote healthcare jobs, but they cater to different stages of a nurse's career.
$25.08 - $51.49/hr
Full-time
This job post has expired 1 day ago. Applications are no longer accepted.
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. The schedule for this role includes holidays and weekends.
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).
• Recent hospital experience in an intensive care unit (ICU) or emergency room.
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: $25.08 - $51.49 / 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
