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Remote Oracle Rn Jobs in Ann Arbor, MI (NOW HIRING)

G-TECH Services, Inc.

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Wellness Coach (REMOTE)

Detroit, MI · Remote

$55K - $65K/yr

Certified Health Education Specialist (CHES), Michigan Licensed Registered Nurse (RN), or American College of Sports Medicine (ACSM) certification. * Certification or progress toward certification is ...

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BetterHelp

Licensed Psychologist - Remote

Detroit, MI · Remote

$650/wk

Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...

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Health Coach (CDCES)

Detroit, MI · Remote

$32 - $35/hr

Remote Health Coach / Certified Diabetes Educators Location: 100% Remote Duration: 12 Months ... Certified Health Education Specialist (CHES) certification, Licensed Registered Nurse (RN), ...

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SalvoHealth

Medical Assistant, Remote

Detroit, MI · Remote

$18 - $22/hr

Experience working in a remote setting * Experience making out-bound calls to patients * Strong ... specialty physicians, registered dietitians, nurses, psychologists, and therapists who have ...

SalvoHealth

Medical Assistant, Remote

Detroit, MI · Remote

$18 - $22/hr

Experience working in a remote setting * Experience making out-bound calls to patients * Strong ... specialty physicians, registered dietitians, nurses, psychologists, and therapists who have ...

SalvoHealth

Medical Assistant, Remote

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$18 - $22/hr

Experience working in a remote setting * Experience making out-bound calls to patients * Strong ... specialty physicians, registered dietitians, nurses, psychologists, and therapists who have ...

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All JobsOracle Rn JobsRemote Oracle Rn JobsRemote Oracle Rn Jobs in Ann Arbor, MI

Remote Oracle Rn information

What is the difference between Remote Oracle Rn vs Remote Oracle Database Administrator?

AspectRemote Oracle RnRemote Oracle Database Administrator
CertificationsOracle Nursing Certification, RN LicenseOracle Certified Professional (OCP), Database Certification
Work EnvironmentHealthcare settings, clinics, hospitalsIT departments, data centers, corporate environments
Job FocusPatient care, clinical proceduresDatabase management, system maintenance

Remote Oracle Rn roles focus on patient care and clinical responsibilities in healthcare settings, requiring nursing licenses and healthcare certifications. In contrast, Remote Oracle Database Administrators handle database systems, requiring IT certifications and technical expertise. Both roles are remote but serve different industries and skill sets, making their job functions distinct despite similar titles.

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Auditor, Healthcare Services (Remote in MI)

Molina Healthcare

Detroit, MI • Remote

Full-time

Posted 19 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 304 rated insurance

Job description

JOB DESCRIPTION 

This position will offer remote work flexibility, but the selected candidate must reside in Michigan. 

Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.  The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams.  Knowledge and experience working with Waiver Program is vital to success in this role. 

The preferred candidate will have 3 - 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking.  Licensure should be an LPC, RN, LLMSW, LMSW, LBSW.

Hours are Monday - Friday, 8:30AM - 5PM EST. 

Job Summary

Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. 

Essential Job Duties


Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed. 
Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met. 
Assesses clinical staff regarding appropriate clinical decision-making. 
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership. 
Ensures auditing approaches follow a Molina standard in approach and tool use. 
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications. 
Adheres to departmental standards, policies and protocols. 
Maintains detailed records of auditing results. 
Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results. 
Meets minimum production standards related to clinical auditing. 
May conduct staff trainings as needed.  Communicates with quality and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct. 

Required Qualifications

At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.

Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.

Strong attention to detail and organizational skills.

Strong analytical and problem-solving skills.

Ability to work in a cross-functional, professional environment.

Ability to work on a team and independently. Excellent verbal and written communication skills.

Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications


Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.
 

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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Benefits

Hours and flexibility

Workplace

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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

Social media

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