Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN)(Behavioral Health)
Waukesha, WI · On-site
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN)(Behavioral Health)
Waukesha, WI · On-site
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN)(Behavioral Health)
Madison, WI · On-site
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN)(Behavioral Health)
Madison, WI · On-site
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN)(Behavioral Health)
Kenosha, WI · On-site
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN)(Behavioral Health)
Kenosha, WI · On-site
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Mesa, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Mesa, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Scottsdale, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Scottsdale, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Phoenix, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Phoenix, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Chandler, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Chandler, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Tucson, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Tucson, AZ · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Long Beach, CA · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN)
Long Beach, CA · Remote
$26.41 - $51.49/hr
Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary ... We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ...
Care Review Clinician (RN) - Remote in FL
Orlando, FL · Remote
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN) - Remote in FL
Orlando, FL · Remote
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Manager (RN)
Biloxi, MS · On-site
$23.76 - $51.49/hr
Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $23.76 - $51.49 ...
Care Manager (RN)
Biloxi, MS · On-site
$23.76 - $51.49/hr
Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $23.76 - $51.49 ...
Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Manager (RN)
Southaven, MS · On-site
$23.76 - $51.49/hr
Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $23.76 - $51.49 ...
Care Manager (RN)
Southaven, MS · On-site
$23.76 - $51.49/hr
Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $23.76 - $51.49 ...
Care Manager (RN)
Vicksburg, MS · On-site
$23.76 - $51.49/hr
... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $23.76 - $51.49 ...
Care Manager (RN)
Vicksburg, MS · On-site
$23.76 - $51.49/hr
... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $23.76 - $51.49 ...
Care Manager (RN) - Washington, Utah and Nevada
Vancouver, WA · On-site
$30.37 - $59.21/hr
... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Care Manager (RN) - Washington, Utah and Nevada
Vancouver, WA · On-site
$30.37 - $59.21/hr
... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Care Manager (RN) - Washington, Utah and Nevada
$30.37 - $59.21/hr
... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Care Manager (RN) - Washington, Utah and Nevada
$30.37 - $59.21/hr
... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Care Manager (RN) - Washington, Utah and Nevada
$30.37 - $59.21/hr
... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Care Manager (RN) - Washington, Utah and Nevada
$30.37 - $59.21/hr
... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Molina Healthcare Rn information
What are the key skills and qualifications needed to thrive as a Molina Healthcare RN, and why are they important?
To thrive as a Molina Healthcare RN, you need a current RN license, comprehensive clinical assessment abilities, and experience in care coordination or case management. Familiarity with electronic health records (EHRs), telehealth systems, and utilization management software is typically expected. Strong communication, problem-solving, and organizational skills help RNs build trust with patients and collaborate effectively with multidisciplinary teams. These skills ensure effective patient care coordination, compliance with healthcare regulations, and positive health outcomes in a managed care environment.
What are some common challenges Molina Healthcare RNs face when coordinating care for members?
Molina Healthcare RNs often encounter challenges such as managing complex patient needs across various providers, ensuring timely communication among interdisciplinary teams, and addressing social determinants of health that can affect care outcomes. Balancing a high caseload while maintaining personalized attention to each member requires strong organizational and time management skills. Additionally, RNs must stay current with Molina’s care management protocols and adapt to frequent updates in healthcare regulations and insurance policies.
What are Molina Healthcare RNs?
Molina Healthcare RNs are registered nurses who work for Molina Healthcare, a managed care organization that provides health plans and services to individuals and families. These nurses typically play roles in case management, care coordination, utilization review, and member education, helping ensure that patients receive appropriate and quality healthcare services. Molina Healthcare RNs may work remotely or in clinical settings, collaborating with physicians, social workers, and other healthcare professionals to support members' health needs and improve outcomes. They are essential in guiding members through complex healthcare systems and advocating for patient-centered care.
What is the difference between Molina Healthcare Rn vs Molina Healthcare Lpn?
| Aspect | Molina Healthcare Rn | Molina Healthcare Lpn |
|---|---|---|
| Required Credentials | Registered Nurse (RN) license, BSN often preferred | Licensed Practical Nurse (LPN) license |
| Work Environment | Clinical settings, patient care, case management | Assisting RNs, basic patient care, administrative tasks |
| Employer & Industry Usage | Hospitals, clinics, insurance companies like Molina | Long-term care facilities, clinics, insurance providers |
The main difference between Molina Healthcare Rn and Molina Healthcare Lpn lies in their credentials and scope of practice. RNs have a broader scope, often handling complex patient care and case management, while LPNs provide basic nursing care under supervision. Both roles are essential in healthcare settings, especially within Molina's insurance and healthcare services.
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Full-time
Posted 16 days ago
Molina Healthcare rating
8.0
Based on 191 frontline employees who took The Breakroom Quiz
147th of 258 rated insurance
Job description
JOB DESCRIPTION
Behavioral Health experience required.
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).
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
What Molina Healthcare employees say
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About Molina Healthcare
Sourced by ZipRecruiter
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.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Long Beach, CA, US
Year founded
1980