Tampa, FL · Remote
$26.41 - $43/hr
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 ...
Tampa, FL · Remote
$26.41 - $43/hr
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 ...
Orlando, FL · Remote
$26.41 - $43/hr
... 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 ...
Orlando, FL · Remote
$26.41 - $43/hr
... 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 ...
Saint Petersburg, FL · Remote
$26.41 - $43/hr
... 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 ...
Saint Petersburg, FL · Remote
$26.41 - $43/hr
... 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 ...
Tampa, FL · Remote
$26.41 - $43/hr
... 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 ...
Tampa, FL · Remote
$26.41 - $43/hr
... 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 ...
Orlando, FL · Remote
$26.41 - $43/hr
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 ...
Orlando, FL · Remote
$26.41 - $43/hr
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 ...
Saint Petersburg, FL · Remote
$26.41 - $43/hr
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 ...
Saint Petersburg, FL · Remote
$26.41 - $43/hr
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 ...
Miami, FL · Remote
$26.41 - $43/hr
... 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 ...
Miami, FL · Remote
$26.41 - $43/hr
... 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 ...
Jacksonville, FL · Remote
$26.41 - $43/hr
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 ...
Jacksonville, FL · Remote
$26.41 - $43/hr
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 ...
... Manager, RN. PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to ... This position is remote with a preference of working hybrid out of one of our AmTrust office ...
... Manager, RN. PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to ... This position is remote with a preference of working hybrid out of one of our AmTrust office ...
... Manager, RN. PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to ... This position is remote with a preference of working hybrid out of one of our AmTrust office ...
... Manager, RN. PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to ... This position is remote with a preference of working hybrid out of one of our AmTrust office ...
Saint Petersburg, FL · Remote
$26.41 - $43/hr
... 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 ...
Saint Petersburg, FL · Remote
$26.41 - $43/hr
... 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 ...
Miami, FL · Remote
$26.41 - $43/hr
... 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 ...
Miami, FL · Remote
$26.41 - $43/hr
... 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 ...
... Manager, RN. PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to ... This position is remote with a preference of working hybrid out of one of our AmTrust office ...
... Manager, RN. PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to ... This position is remote with a preference of working hybrid out of one of our AmTrust office ...
Jacksonville, FL · Remote
$26.41 - $43/hr
... 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 ...
Jacksonville, FL · Remote
$26.41 - $43/hr
... 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 ...
Fort Lauderdale, FL · Remote
$26.41 - $43/hr
... 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 ...
Fort Lauderdale, FL · Remote
$26.41 - $43/hr
... 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 ...
Jacksonville, FL · Remote
$26.41 - $43/hr
... 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 ...
Jacksonville, FL · Remote
$26.41 - $43/hr
... 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 ...
Orlando, FL · Remote
$26.41 - $43/hr
... 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 ...
Orlando, FL · Remote
$26.41 - $43/hr
... 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 ...
Miami, FL · Remote
$26.41 - $43/hr
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 ...
Miami, FL · Remote
$26.41 - $43/hr
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 ...
Orlando, FL · On-site +1
$72K - $92K/yr
... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure preferred; or graduate degree in health or human services field required with one of ...
Orlando, FL · On-site +1
$72K - $92K/yr
... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure preferred; or graduate degree in health or human services field required with one of ...
Orlando, FL · On-site +1
$72K - $92K/yr
... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure preferred; or graduate degree in health or human services field required with one of ...
Orlando, FL · On-site +1
$72K - $92K/yr
... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure preferred; or graduate degree in health or human services field required with one of ...
| 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.
$26.41 - $43/hr
Full-time
Re-posted 11 days ago
8.1
Based on 193 frontline employees who took The Breakroom Quiz
134th of 281 rated insurance
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
Pay Range: $26.41 - $43 / 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
