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Remote Optum Rn Jobs in Cerritos, CA (NOW HIRING)

CommonSpirit Health

Care Transformation RN

Los Angeles, CA · Remote

$41.14 - $67.88/hr

Job Summary and Responsibilities Thiis is a remote position requring travel to support enterprise ... Serve as a Virtual RN (VIC RN) for 50% of the role, providing direct patient care during ...

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Zócalo Health

RN Case Manager

Los Angeles, CA · Remote

$85K/yr

RN Case Manager Remote (Full Time) *Must reside in California* Compensation: $85,000 About Us Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have ...

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All JobsOptum Rn JobsRemote Optum Rn JobsRemote Optum Rn Jobs in Cerritos, CA

Remote Optum Rn information

What is the difference between Remote Optum Rn vs Remote UnitedHealth Group Rn?

AspectRemote Optum RnRemote UnitedHealth Group Rn
CredentialsRegistered Nurse (RN) license, applicable certificationsRegistered Nurse (RN) license, applicable certifications
Work EnvironmentRemote healthcare services, telehealth platformsRemote healthcare services, telehealth platforms
Employer & IndustryOptum, healthcare and health services industryUnitedHealth 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 popular job titles related to Remote Optum Rn jobs in Cerritos, CA? For Remote Optum Rn jobs in Cerritos, CA, the most frequently searched job titles are:
What job categories do people searching Remote Optum Rn jobs in Cerritos, CA look for? The top searched job categories for Remote Optum Rn jobs in Cerritos, CA are:
What cities near Cerritos, CA are hiring for Remote Optum Rn jobs? Cities near Cerritos, CA with the most Remote Optum Rn job openings:
Remote Optum Rn jobs near you
Infographic showing various Remote Optum Rn job openings in Cerritos, CA as of July 2026, with employment types broken down into 1% As Needed, 87% Full Time, and 12% Part Time. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Care Review Clinician (RN) Remote

Molina Healthcare

Long Beach, CA • Remote

Full-time

Posted 29 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 197 frontline employees who took The Breakroom Quiz

161st of 300 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

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