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Molina Healthcare Rn Jobs in California (NOW HIRING)

Molina Healthcare

Care Manager (RN)

Long Beach, CA · On-site

$30.37 - $59.21/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: $30.37 - $59.21 ...

Molina Healthcare

RN Care Manager - STARS

Long Beach, CA · On-site

$27.73 - $54.06/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: $27.73 - $54.06 ...

Molina Healthcare

RN Care Manager - STARS

Long Beach, CA · On-site

$26.41 - $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: $26.41 - $51.49 ...

Molina Healthcare

RN Care Manager - STARS

Fresno, CA

$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 Care Manager - STARS

Los Angeles, CA · 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 ...

Molina Healthcare

RN Care Manager - STARS

Bakersfield, CA · 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 ...

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Molina Healthcare Rn information

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 is the difference between Molina Healthcare Rn vs Molina Healthcare Lpn?

AspectMolina Healthcare RnMolina Healthcare Lpn
Required CredentialsRegistered Nurse (RN) license, BSN often preferredLicensed Practical Nurse (LPN) license
Work EnvironmentClinical settings, patient care, case managementAssisting RNs, basic patient care, administrative tasks
Employer & Industry UsageHospitals, clinics, insurance companies like MolinaLong-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.

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 is a Molina Healthcare RN?

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 are popular job titles related to Molina Healthcare Rn jobs in California? For Molina Healthcare Rn jobs in California, the most frequently searched job titles are:
What job categories do people searching Molina Healthcare Rn jobs in California look for? The top searched job categories for Molina Healthcare Rn jobs in California are:
What cities in California are hiring for Molina Healthcare Rn jobs? Cities in California with the most Molina Healthcare Rn job openings:
Molina Healthcare Rn jobs near you
Infographic showing various Molina Healthcare Rn job openings in California as of August 2026, with employment types broken down into 2% As Needed, 69% Full Time, 15% Part Time, 2% Temporary, and 12% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution.

Care Review Clinician (RN)

Molina Healthcare

San Jose, CA • On-site

Other

Medical

Posted 5 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

163rd of 304 rated insurance

Job description

Job Title

Clinical Member Services Reviewer

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

  • Assess 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.

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

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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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

Social media

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