Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Recent hospital experience in an intensive care unit (ICU) or emergency room. #PJHS3 #LI-AC1 To all ...
Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Recent hospital experience in an intensive care unit (ICU) or emergency room. #PJHS3 #LI-AC1 To all ...
Care Review Clinician (RN) - Remote in FL
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... care unit (ICU) or emergency room. #PJHS3 #LI-AC1 To all current Molina employees: If you are ...
Care Review Clinician (RN) - Remote in FL
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... care unit (ICU) or emergency room. #PJHS3 #LI-AC1 To all current Molina employees: If you are ...
Care Review Clinician (RN) - Remote in FL
Long Beach, CA · Remote
$26.41 - $51.49/hr
Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Recent hospital experience in an intensive care unit (ICU) or emergency room. #PJHS3 #LI-AC1 To all ...
Care Review Clinician (RN) - Remote in FL
Long Beach, CA · Remote
$26.41 - $51.49/hr
Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Recent hospital experience in an intensive care unit (ICU) or emergency room. #PJHS3 #LI-AC1 To all ...
RN Clinical Supervisor
Napa, CA · Remote
$60 - $70/hr
Support transitions of care from NICU/PICU to the home. Mentor nurses delivering long-term ... Remote, flexible schedule. Leadership role across pediatric and adult skilled nursing. High-touch ...
Quick apply
RN Clinical Supervisor
Napa, CA · Remote
$60 - $70/hr
Support transitions of care from NICU/PICU to the home. Mentor nurses delivering long-term ... Remote, flexible schedule. Leadership role across pediatric and adult skilled nursing. High-touch ...
RN Clinical Supervisor
Napa, CA · Remote
$60 - $70/hr
... U/PICU to the home. • Mentor nurses delivering long-term pediatric shift care. • Ensure ... Why Join Us? • $60/hour compensation. • Remote, flexible schedule. • Leadership role across ...
RN Clinical Supervisor
Napa, CA · Remote
$60 - $70/hr
... U/PICU to the home. • Mentor nurses delivering long-term pediatric shift care. • Ensure ... Why Join Us? • $60/hour compensation. • Remote, flexible schedule. • Leadership role across ...
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina ...
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina ...
Care Review Clinician (RN)
Long Beach, CA · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina ...
Care Review Clinician (RN)
Long Beach, CA · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina ...
Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina ...
Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina ...
(RN) Care Review Clinician - Weekend Role (REMOTE)
Long Beach, CA · On-site +1
$25.08 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
(RN) Care Review Clinician - Weekend Role (REMOTE)
Long Beach, CA · On-site +1
$25.08 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
Care Review Clinician (RN)(Behavioral Health)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
Care Review Clinician (RN)(Behavioral Health)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
(RN) Care Review Clinician - Weekend Role (REMOTE)
Long Beach, CA · Remote
$25.08 - $51.49/hr
Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina ...
(RN) Care Review Clinician - Weekend Role (REMOTE)
Long Beach, CA · Remote
$25.08 - $51.49/hr
Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ... Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina ...
Care Review Clinician (RN) Weekends
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
Care Review Clinician (RN) Weekends
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ... an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are ...
Physical Therapist (ICU Program Coordinator)
San Francisco, CA · On-site +1
$160K - $209K/yr
This position is embedded in a mixed medical and surgical ICU and provides clinical and administrative direction to other interdisciplinary team members regarding program elements in physical therapy.
Physical Therapist (ICU Program Coordinator)
San Francisco, CA · On-site +1
$160K - $209K/yr
This position is embedded in a mixed medical and surgical ICU and provides clinical and administrative direction to other interdisciplinary team members regarding program elements in physical therapy.
... U maternity unit, along with a cancer center, urgent care locations, and a growing network of ... Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ...
New
... U maternity unit, along with a cancer center, urgent care locations, and a growing network of ... Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ...
New
Current CA RN licensure and AHA BLS. * Weekend supervision of clinical staff 0830-1700 is remote ... , heart care, cancer care, women's health, and neurology. Additionally, Mercy San Juan Medical ...
Current CA RN licensure and AHA BLS. * Weekend supervision of clinical staff 0830-1700 is remote ... , heart care, cancer care, women's health, and neurology. Additionally, Mercy San Juan Medical ...
Licensed Vocational Nurse (LVN)- 1800 Acute Care Unit (Part Time, Night)
Fairfield, CA · On-site +1
$28 - $37.75/hr
... the registered nurse. The LVN, utilizing Jean Watson's Nursing Theory of Caring and the ... Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ...
Licensed Vocational Nurse (LVN)- 1800 Acute Care Unit (Part Time, Night)
Fairfield, CA · On-site +1
$28 - $37.75/hr
... the registered nurse. The LVN, utilizing Jean Watson's Nursing Theory of Caring and the ... Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ...
Licensed Vocational Nurse (LVN)- 1800 Acute Care Unit (Part Time, Day)
Fairfield, CA · On-site +1
$28 - $37.75/hr
... the registered nurse. The LVN, utilizing Jean Watson's Nursing Theory of Caring and the ... Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ...
Licensed Vocational Nurse (LVN)- 1800 Acute Care Unit (Part Time, Day)
Fairfield, CA · On-site +1
$28 - $37.75/hr
... the registered nurse. The LVN, utilizing Jean Watson's Nursing Theory of Caring and the ... Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ...
... U maternity unit, along with a cancer center, urgent care locations, and a growing network of ... Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ...
... U maternity unit, along with a cancer center, urgent care locations, and a growing network of ... Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ...
Remote Icu Rn information
How does a Remote ICU RN collaborate with on-site healthcare teams to ensure optimal patient care?
What are the key skills and qualifications needed to thrive as a Remote ICU RN, and why are they important?
What are Remote ICU RNs?

Full-time
Posted 7 days ago
Molina Healthcare rating
8.0
Based on 192 frontline employees who took The Breakroom Quiz
145th of 260 rated insurance
Job description
JOB DESCRIPTION
Must reside in Florida
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
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About Molina Healthcare
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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.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Long Beach, CA, US
Year founded
1980