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) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... N will act as a Care Review Clinician supporting our Medicare members. The position is fully remote ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... N will act as a Care Review Clinician supporting our Medicare members. The position is fully remote ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN) Remote (AZ)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN) Remote (AZ)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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) Remote (AZ)
Avondale, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN) Remote (AZ)
Avondale, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
The position is fully remote. Excellent computer skills and attention to detail are very important ... Conducts reviews to determine prior authorization/financial responsibility for Molina and its ...
The position is fully remote. Excellent computer skills and attention to detail are very important ... Conducts reviews to determine prior authorization/financial responsibility for Molina and its ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
The position is fully remote. Excellent computer skills and attention to detail are very important ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
The position is fully remote. Excellent computer skills and attention to detail are very important ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicare members who have recently been ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicare members who have recently been ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Care Review Clinician (RN) Remote (AZ)
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 ... Conducts reviews to determine prior authorization/financial responsibility for Molina and its ...
Care Review Clinician (RN) Remote (AZ)
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 ... Conducts reviews to determine prior authorization/financial responsibility for Molina and its ...
Care Review Clinician (RN) Remote (AZ)
Glendale, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN) Remote (AZ)
Glendale, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN) Remote (AZ)
Tucson, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN) Remote (AZ)
Tucson, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN) Remote (AZ)
Phoenix, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN) Remote (AZ)
Phoenix, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN) Remote (AZ)
Gilbert, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
Care Review Clinician (RN) Remote (AZ)
Gilbert, AZ · Remote
$26.41 - $51.49/hr
Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 ...
(RN) REMOTE Care Manager - High Risk OB
Long Beach, CA · Remote
$26.41 - $51.49/hr
This is a remote telephonic care manager position with a speciality in helping members navigate ... Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate ...
(RN) REMOTE Care Manager - High Risk OB
Long Beach, CA · Remote
$26.41 - $51.49/hr
This is a remote telephonic care manager position with a speciality in helping members navigate ... Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate ...
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
**Fully remote opportunity requiring an active Illinois nursing license. The role operates Monday ... Conducts reviews to determine prior authorization/financial responsibility for Molina and its ...
**Fully remote opportunity requiring an active Illinois nursing license. The role operates Monday ... Conducts reviews to determine prior authorization/financial responsibility for Molina and its ...
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Lincoln, NE · Remote
$27.59 - $56.63/hr
This position will offer remote work flexibility, but the selected candidate must reside in ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $27.59 - $56.63 ...
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Lincoln, NE · Remote
$27.59 - $56.63/hr
This position will offer remote work flexibility, but the selected candidate must reside in ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $27.59 - $56.63 ...
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Lincoln, NE · Remote
$27.59 - $56.63/hr
Ensures auditing approaches follow a Molina standard in approach and tool use. Maintains member ... Registered Nurse (RN). License must be active and restricted in state of practice. Strong attention ...
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Lincoln, NE · Remote
$27.59 - $56.63/hr
Ensures auditing approaches follow a Molina standard in approach and tool use. Maintains member ... Registered Nurse (RN). License must be active and restricted in state of practice. Strong attention ...
Remote Molina Nurse information
See salary details
$17.31 - $21.68
3% of jobs
$21.68 - $26.05
7% of jobs
$29.33 is the 25th percentile. Wages below this are outliers.
$26.05 - $30.42
20% of jobs
The median wage is $34.13 / hr.
$30.42 - $34.79
24% of jobs
$34.79 - $39.16
14% of jobs
$41.84 is the 75th percentile. Wages above this are outliers.
$39.16 - $43.53
11% of jobs
$43.53 - $47.90
7% of jobs
$47.90 - $52.27
5% of jobs
$52.27 - $56.64
3% of jobs
$56.64 - $61.01
3% of jobs
$61.01 - $65.38
2% of jobs
$17
$38
$65
How much do remote molina nurse jobs pay per hour?
What is the difference between Remote Molina Nurse vs Remote Medical Coder?
| Aspect | Remote Molina Nurse | Remote Medical Coder |
|---|---|---|
| Required Credentials | RN license, state-specific licensing, CPR certification | Certification (CPC, CCS), coding credentials |
| Work Environment | Home-based, healthcare provider setting | Home-based, healthcare administration setting |
| Employer & Industry Usage | Health insurance companies, healthcare providers | Hospitals, insurance companies, billing services |
| Common Search & Comparison | Remote Molina Nurse vs Remote Medical Coder |
The Remote Molina Nurse primarily provides patient care and case management within health insurance settings, requiring nursing credentials. In contrast, the Remote Medical Coder focuses on translating medical records into billing codes, requiring coding certifications. Both roles are home-based and serve the healthcare industry, but they differ in responsibilities and required qualifications.

Full-time
Posted 26 days ago
Molina Healthcare rating
8.0
Based on 196 frontline employees who took The Breakroom Quiz
161st of 299 rated insurance
Job description
This RN will act as a Care Review Clinician supporting our Medicare members. The position is fully remote. Excellent computer skills and attention to detail are very important to multitask between systems, talk with providers on the phone, and adhere to Medicare guidelines.
This is a remote position and productivity is important. Preferred candidates will have previous utilization management, managed care, or post-acute experience.
Schedule: Monday through Friday 8:30AM to 5:00PM EST (Occasional weekends, no nights, occasional holidays.)
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
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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