Jacksonville Beach, FL · 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 ...
Jacksonville Beach, FL · 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 ...
Chehalis, WA · Hybrid
$26.41 - $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: $26.41 - $59.21 ...
Chehalis, WA · Hybrid
$26.41 - $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: $26.41 - $59.21 ...
Spokane, WA · On-site
$26.41 - $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: $26.41 - $59.21 ...
Spokane, WA · On-site
$26.41 - $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: $26.41 - $59.21 ...
$26.41 - $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: $26.41 - $59.21 ...
$26.41 - $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: $26.41 - $59.21 ...
Boston, MA · 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 ...
Boston, MA · 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 ...
Myrtle Beach, SC · On-site
$25.08 - $51.49/hr
... RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.08 - $51.49 ...
Myrtle Beach, SC · On-site
$25.08 - $51.49/hr
... RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.08 - $51.49 ...
$25.08 - $51.49/hr
... RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.08 - $51.49 ...
$25.08 - $51.49/hr
... RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.08 - $51.49 ...
$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 ...
$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 ...
Dallas, TX · On-site
$54K - $107K/yr
... RN license highly preferred #LI-AC1 #HTF #PJCorp To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare ...
Dallas, TX · On-site
$54K - $107K/yr
... RN license highly preferred #LI-AC1 #HTF #PJCorp To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare ...
$25.08 - $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: $25.08 - $51.49 ...
$25.08 - $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: $25.08 - $51.49 ...
Bothell, WA · On-site
$26.41 - $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
Bothell, WA · On-site
$26.41 - $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
Miami, FL · 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 ...
Miami, FL · 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 ...
$25.08 - $51.49/hr
... RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.08 - $51.49 ...
$25.08 - $51.49/hr
... RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $25.08 - $51.49 ...
$26.41 - $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: $26.41 - $51.49 ...
$26.41 - $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: $26.41 - $51.49 ...
Phoenix, AZ · Remote
$26.41 - $51.49/hr
We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Phoenix, AZ · Remote
$26.41 - $51.49/hr
We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Los Angeles, CA · Remote
$30.37 - $59.21/hr
Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Los Angeles, CA · Remote
$30.37 - $59.21/hr
Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Long Beach, CA · On-site
$23.76 - $51.49/hr
Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $23.76 - $51.49 ...
Long Beach, CA · On-site
$23.76 - $51.49/hr
Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $23.76 - $51.49 ...
$26.41 - $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: $26.41 - $51.49 ...
$26.41 - $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: $26.41 - $51.49 ...
Logan, OH · On-site
$26.41 - $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
Logan, OH · On-site
$26.41 - $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
Hillsboro, OH · 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 ...
Hillsboro, OH · 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 ...
| 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.
$26.41 - $51.49/hr
Full-time
Posted 17 days ago
8.0
Based on 199 frontline employees who took The Breakroom Quiz
163rd of 304 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).
• Recent hospital experience in an intensive care unit (ICU) or emergency room.
#PJHS3
#LI-AC1
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: $26.41 - $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
