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Remote Humana Rn Jobs in California (NOW HIRING)

Molina Healthcare

Care Manager, LTSS (RN)

Long Beach, CA · On-site +1

$26.41 - $51.49/hr

***Remote with travel throughout Dane County, WI for member visits*** Job Summary Provides support for ... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ...

Molina Healthcare

Care Manager, LTSS (RN)

Long Beach, CA · On-site +1

$26.41 - $51.49/hr

***Remote with travel throughout Dane County, WI for member visits*** Job Summary Provides support for ... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ...

Molina Healthcare

Care Manager, LTSS (RN)

Long Beach, CA · On-site +1

$26.41 - $51.49/hr

***Remote and will travel throughout the Southwest and Western regions of Wisconsin for member ... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ...

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Remote Humana Rn information

What is the difference between Remote Humana Rn vs Remote UnitedHealthcare Rn?

AspectRemote Humana RnRemote UnitedHealthcare Rn
CredentialsRN license, applicable certificationsRN license, applicable certifications
Work EnvironmentRemote, telehealth settingsRemote, telehealth settings
Employer & IndustryHumana, health insurance industryUnitedHealthcare, health insurance industry
Common Search IntentComparison of remote nursing roles in Humana and similar companiesComparison of remote nursing roles in UnitedHealthcare and similar companies

Both Remote Humana Rn and Remote UnitedHealthcare Rn roles involve providing patient care remotely within the health insurance industry. They require similar credentials, such as an active RN license and relevant certifications. The primary difference lies in the employer and specific company policies, but the work environment and job responsibilities are largely comparable, focusing on telehealth services for members of their respective health plans.

What are popular job titles related to Remote Humana Rn jobs in California? For Remote Humana Rn jobs in California, the most frequently searched job titles are:
What job categories do people searching Remote Humana Rn jobs in California look for? The top searched job categories for Remote Humana Rn jobs in California are:
What cities in California are hiring for Remote Humana Rn jobs? Cities in California with the most Remote Humana Rn job openings:
Remote Humana Rn jobs near you
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska

Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska

Molina Healthcare

Long Beach, CA • Remote

$27.59 - $56.63/hr

Full-time

Re-posted 4 days ago

Molina Healthcare rating

8.1

Company rating: 8.1 out of 10

Based on 193 frontline employees who took The Breakroom Quiz

134th of 281 rated insurance

Job description

JOB DESCRIPTION 

This position will offer remote work flexibility, but the selected candidate must reside in Nebraska. 

Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.  The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams.  Knowledge and experience working with NCQA standards is vital to success in this role. The preferred candidate will have 3 - 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking. Hours are Monday - Friday, 8AM - 5PM in your time zone. 

Job Summary

Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. 
 

Essential Job Duties


Performs audits in care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed. 
Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met. 
Assesses clinical staff regarding appropriate clinical decision-making. 
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership. 
Ensures auditing approaches follow a Molina standard in approach and tool use. 
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications. 
Adheres to departmental standards, policies and protocols. 
Maintains detailed records of auditing results. 
Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results. 
Meets minimum production standards related to clinical auditing. 
May conduct staff trainings as needed.  Communicates with quality and/or healthcare services leadership regarding issues identified and works collaboratively to subsequently resolve/correct. 

Required Qualifications


At least 2 years health care experience, with at least 1 year experience in care management, and/or managed care, or equivalent combination of relevant education and experience. 
Registered Nurse (RN). License must be active and restricted in state of practice. 
Strong attention to detail and organizational skills. 
Strong analytical and problem-solving skills. 
Ability to work in a cross-functional, professional environment. 
Ability to work on a team and independently. 
Excellent verbal and written communication skills. 
Microsoft Office suite/applicable software program(s) proficiency. 

Preferred Qualifications


Care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.
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: $27.59 - $56.63 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

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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

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