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Remote Molina Nurse Jobs (NOW HIRING)

Molina Healthcare

Care Manager (RN) Remote

$23.76 - $51.49/hr

This RN will act as a Care Manager supporting our Medicaid, Medicare and Marketplace members who ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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How much do remote molina nurse jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for remote molina nurse in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.

What is the difference between Remote Molina Nurse vs Remote Medical Coder?

AspectRemote Molina NurseRemote Medical Coder
Required CredentialsRN license, state-specific licensing, CPR certificationCertification (CPC, CCS), coding credentials
Work EnvironmentHome-based, healthcare provider settingHome-based, healthcare administration setting
Employer & Industry UsageHealth insurance companies, healthcare providersHospitals, insurance companies, billing services
Common Search & ComparisonRemote 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.

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What cities are hiring for Remote Molina Nurse jobs? Cities with the most Remote Molina Nurse job openings:
What are the most commonly searched types of Molina Nurse jobs? The most popular types of Molina Nurse jobs are:
What states have the most Remote Molina Nurse jobs? States with the most job openings for Remote Molina Nurse jobs include:
What job categories do people searching Remote Molina Nurse jobs look for? The top searched job categories for Remote Molina Nurse jobs are:
Remote Molina Nurse jobs near you
Infographic showing various Remote Molina Nurse job openings in the United States as of July 2026, with employment types broken down into 3% As Needed, 59% Full Time, 15% Part Time, and 23% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $80,321 per year, or $38.6 per hour.

Care Review Clinician (RN) Remote

Molina Healthcare

Remote

$23.76 - $51.49/hr

Full-time

Posted 25 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 198 frontline employees who took The Breakroom Quiz

163rd of 303 rated insurance

Job description


JOB DESCRIPTION
This RN will act as a Care Review Clinician and provide clinical review support for Medicare inpatient utilization management activities. Conducts medical necessity reviews of inpatient admissions and ongoing services using established clinical guidelines, Medicare requirements, and organizational policies. Partners with providers, case management, and care coordination teams to facilitate appropriate care delivery, support member outcomes, and ensure regulatory compliance. Contributes to quality, affordability, and effective resource stewardship through accurate and timely utilization review decisions.
This is a telephonic position and productivity is important. Preferred candidates will have previous case management, managed care, or inpatient hospital experience. Experience in a behavioral health setting would be a plus.
Schedule: Tuesday through Saturday 8 hr shifts daylight schedule (Training Mon- Friday) (No nights, holiday rotation, no call.) Alternative work schedule ava after 18 weeks exp: 8 - 10-hour shifts (Tues-Sat 8 hours or Friday-Monday 10 hours)
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

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