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 ...
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 ...
(RN)Care Manager - Nevada Based
Long Beach, CA · Remote
$27.73 - $54.06/hr
This role is primarily remote but may include some local field travel. The target area for this ... Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ...
(RN)Care Manager - Nevada Based
Long Beach, CA · Remote
$27.73 - $54.06/hr
This role is primarily remote but may include some local field travel. The target area for this ... Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ...
(RN)Care Manager - Nevada Based
Long Beach, CA · On-site +1
$27.73 - $54.06/hr
This role is primarily remote but may include some local field travel. The target area for this ... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ...
(RN)Care Manager - Nevada Based
Long Beach, CA · On-site +1
$27.73 - $54.06/hr
This role is primarily remote but may include some local field travel. The target area for this ... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
Location: 100% Remote ****FLEXIBLE HOURS (Set your schedule) ***ONLY CALIFORNIA LICENSED We are seeking an experienced and compassionate Nurse Practitioner (NP) licensed in California to conduct ...
Location: 100% Remote ****FLEXIBLE HOURS (Set your schedule) ***ONLY CALIFORNIA LICENSED We are seeking an experienced and compassionate Nurse Practitioner (NP) licensed in California to conduct ...
Location: 100% Remote ****FLEXIBLE HOURS (Set your schedule) ***ONLY CALIFORNIA LICENSED We are seeking an experienced and compassionate Nurse Practitioner (NP) licensed in California to conduct ...
Location: 100% Remote ****FLEXIBLE HOURS (Set your schedule) ***ONLY CALIFORNIA LICENSED We are seeking an experienced and compassionate Nurse Practitioner (NP) licensed in California to conduct ...
Lead Customer Solution Center Appeals and Grievances RN
Los Angeles, CA · Remote
$132K - $163K/yr
Job Summary The Lead Appeals and Grievances RN is responsible for assisting with the development of ... holidays, a hybrid remote schedule, and occasional flexibility in hours/shift in critical ...
Lead Customer Solution Center Appeals and Grievances RN
Los Angeles, CA · Remote
$132K - $163K/yr
Job Summary The Lead Appeals and Grievances RN is responsible for assisting with the development of ... holidays, a hybrid remote schedule, and occasional flexibility in hours/shift in critical ...
Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ... Current California RN license required. * Certified Nurse Operating Room required. * Certification ...
Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of ... Current California RN license required. * Certified Nurse Operating Room required. * Certification ...
Remote Primary Care Provider (NP/PA)
Round Mountain, CA · On-site +1
$106K - $137K/yr
Remote Primary Care Provider (NP/PA) - Desktop Care Department: Medical Reports To: Chief Medical ... Collaborate closely with RNs, LVNs, MAs, and care coordination teams Telehealth & Patient Care
Remote Primary Care Provider (NP/PA)
Round Mountain, CA · On-site +1
$106K - $137K/yr
Remote Primary Care Provider (NP/PA) - Desktop Care Department: Medical Reports To: Chief Medical ... Collaborate closely with RNs, LVNs, MAs, and care coordination teams Telehealth & Patient Care
Remote Primary Care Provider (NP/PA)
Round Mountain, CA · Remote
$101K - $138K/yr
Remote Primary Care Provider (NP/PA) - Desktop Care Department: Medical Reports To: Chief Medical ... Collaborate closely with RNs, LVNs, MAs, and care coordination teams Telehealth & Patient Care
Remote Primary Care Provider (NP/PA)
Round Mountain, CA · Remote
$101K - $138K/yr
Remote Primary Care Provider (NP/PA) - Desktop Care Department: Medical Reports To: Chief Medical ... Collaborate closely with RNs, LVNs, MAs, and care coordination teams Telehealth & Patient Care
Registered Nurses (Data labelling and training) Type: Contract Compensation: $60-$80/hour Location: Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ...
Quick apply
Registered Nurses (Data labelling and training) Type: Contract Compensation: $60-$80/hour Location: Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · On-site +1
$25.08 - $51.49/hr
SC Single state or Compact RN License. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · On-site +1
$25.08 - $51.49/hr
SC Single state or Compact RN License. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and ...
Registered Nurse (RN). License must be active and unrestricted in state of practice. SC Single state or Compact RN License. Ability to prioritize and manage multiple deadlines. Excellent ...
Registered Nurse (RN). License must be active and unrestricted in state of practice. SC Single state or Compact RN License. Ability to prioritize and manage multiple deadlines. Excellent ...
Care Manager, LTSS (RN) - Holmes County
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This is a remote field-based role requiring travel in Holmes County. Job Summary Provides support ... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ...
Care Manager, LTSS (RN) - Holmes County
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This is a remote field-based role requiring travel in Holmes County. Job Summary Provides support ... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ...
RN Clinical Documentation Integrity Specialist - Remote
Temecula, CA · On-site +1
$93K - $134K/yr
Southwest Healthcare is seeking a Full-Time Remote RN Clinical Documentation Integrity Specialist position. This position provides clinically based concurrent and retrospective review of inpatient ...
RN Clinical Documentation Integrity Specialist - Remote
Temecula, CA · On-site +1
$93K - $134K/yr
Southwest Healthcare is seeking a Full-Time Remote RN Clinical Documentation Integrity Specialist position. This position provides clinically based concurrent and retrospective review of inpatient ...
Strong understanding of both RN and PN scope of practice * Fluency in English with excellent writing, editing, and communication skills * Comfort working in a fast-paced, fully remote, and ...
Quick apply
Strong understanding of both RN and PN scope of practice * Fluency in English with excellent writing, editing, and communication skills * Comfort working in a fast-paced, fully remote, and ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · Remote
$25.08 - $51.49/hr
Registered Nurse (RN). License must be active and unrestricted in state of practice. SC Single state or Compact RN License. Ability to prioritize and manage multiple deadlines. Excellent ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · Remote
$25.08 - $51.49/hr
Registered Nurse (RN). License must be active and unrestricted in state of practice. SC Single state or Compact RN License. Ability to prioritize and manage multiple deadlines. Excellent ...
IRIS Self-Directed Personal Care (RN) (Milwaukee County, WI)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care (SDPC) RN. This is a remote position, where you will partner with people in ...
IRIS Self-Directed Personal Care (RN) (Milwaukee County, WI)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care (SDPC) RN. This is a remote position, where you will partner with people in ...
Remote Optum Rn information
What is the difference between Remote Optum Rn vs Remote UnitedHealth Group Rn?
| Aspect | Remote Optum Rn | Remote UnitedHealth Group Rn |
|---|---|---|
| Credentials | Registered Nurse (RN) license, applicable certifications | Registered Nurse (RN) license, applicable certifications |
| Work Environment | Remote healthcare services, telehealth platforms | Remote healthcare services, telehealth platforms |
| Employer & Industry | Optum, healthcare and health services industry | UnitedHealth Group, healthcare and insurance industry |
Both Remote Optum Rn and Remote UnitedHealth Group Rn roles involve providing remote nursing care within the healthcare industry. They require similar credentials and work environments, often utilizing telehealth platforms. The main difference lies in the employer and specific focus areas within the healthcare sector, with Optum focusing on health services and UnitedHealth Group encompassing broader health insurance and services.
What are the most commonly searched types of Optum Rn jobs in California? The most popular types of Optum Rn jobs in California are:
What are popular job titles related to Remote Optum Rn jobs in California? For Remote Optum Rn jobs in California, the most frequently searched job titles are:
What job categories do people searching Remote Optum Rn jobs in California look for? The top searched job categories for Remote Optum Rn jobs in California are:
What cities in California are hiring for Remote Optum Rn jobs? Cities in California with the most Remote Optum Rn job openings:
Full-time
Re-posted 12 days ago
Molina Healthcare rating
8.1
Based on 193 frontline employees who took The Breakroom Quiz
134th of 281 rated insurance
Job description
JOB DESCRIPTION Job SummaryProvides 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
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
What Molina Healthcare employees say
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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