Sacramento, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Sacramento, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Bakersfield, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Bakersfield, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... 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
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... 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
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
$26.41 - $59.21/hr
Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate ... Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs ...
$26.41 - $59.21/hr
Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate ... Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs ...
San Francisco, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
San Francisco, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
San Jose, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
San Jose, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... . If licensed, license must be active and unrestricted in state of practice. To all current Molina ...
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... . If licensed, license must be active and unrestricted in state of practice. To all current Molina ...
Spokane, WA · On-site +1
$26.41 - $59.21/hr
... s 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
Spokane, WA · On-site +1
$26.41 - $59.21/hr
... s 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
Fresno, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Fresno, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
$25.08 - $51.49/hr
... s 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
... s 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
... s 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
... s 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 ...
Cleveland, OH · Remote
$54K - $107K/yr
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... . If licensed, license must be active and unrestricted in state of practice. To all current Molina ...
Cleveland, OH · Remote
$54K - $107K/yr
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... . If licensed, license must be active and unrestricted in state of practice. To all current Molina ...
$29.05 - $56.64/hr
Must reside in TX and have an active TX RN license in good standing. * Focus of these audits is on ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $29.05 - $56.64 ...
$29.05 - $56.64/hr
Must reside in TX and have an active TX RN license in good standing. * Focus of these audits is on ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $29.05 - $56.64 ...
San Francisco, CA · Remote
$30.37 - $59.21/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...
San Francisco, CA · Remote
$30.37 - $59.21/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...
Cincinnati, OH · Remote
$54K - $107K/yr
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... . If licensed, license must be active and unrestricted in state of practice. To all current Molina ...
Cincinnati, OH · Remote
$54K - $107K/yr
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... . If licensed, license must be active and unrestricted in state of practice. To all current Molina ...
$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
$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
Los Angeles, CA · Remote
$30.37 - $59.21/hr
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... 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
... . License must be active and unrestricted in state of practice. • Ability to prioritize and ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $30.37 - $59.21 ...
Long Beach, CA · Remote
$54K - $107K/yr
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... . If licensed, license must be active and unrestricted in state of practice. To all current Molina ...
Long Beach, CA · Remote
$54K - $107K/yr
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... . If licensed, license must be active and unrestricted in state of practice. To all current Molina ...
Sacramento, CA · Remote
$30.37 - $59.21/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...
Sacramento, CA · Remote
$30.37 - $59.21/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...
$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
| 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.
Cities with the most Remote Molina Nurse job openings:
The most popular types of Molina Nurse jobs are:
States with the most job openings for Remote Molina Nurse jobs include:
The top searched job categories for Remote Molina Nurse jobs are:
Sacramento, CA • Remote
$30.37 - $59.21/hr
Full-time
Re-posted 2 days ago
8.0
Based on 199 frontline employees who took The Breakroom Quiz
163rd of 306 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).
Utilization review, prior authorization, inpatient review desirable. MCG experience, strongly preferred.
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: $30.37 - $59.21 / 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
