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 ...
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 ...
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
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 ...
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
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 ...
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been ... This is a telephonic remote position and productivity is important. Preferred candidates will have ...
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been ... This is a telephonic remote position and productivity is important. Preferred candidates will have ...
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 ...
Quick apply
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 ...
This is a remote telephonic care manager position with a speciality in helping members navigate ... Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ...
This is a remote telephonic care manager position with a speciality in helping members navigate ... Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ...
(RN) REMOTE Care Manager - High Risk OB
Long Beach, CA · Remote
$26.41 - $51.49/hr
This is a remote telephonic care manager position with a speciality in helping members navigate ... Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ...
(RN) REMOTE Care Manager - High Risk OB
Long Beach, CA · Remote
$26.41 - $51.49/hr
This is a remote telephonic care manager position with a speciality in helping members navigate ... Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ...
The position is fully remote. Excellent computer skills and attention to detail are very important ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...
The position is fully remote. Excellent computer skills and attention to detail are very important ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
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 ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
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 ...
We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ... Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ...
We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ... Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ...
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicare members who have recently been ... This is a remote position and productivity is important. Preferred candidates will have previous ...
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicare members who have recently been ... This is a remote position and productivity is important. Preferred candidates will have previous ...
Chronic Care Management LVN - REMOTE (California License Required)
Los Angeles, CA · On-site +1
$25/hr
*FULL TIME REMOTE POSITION* $25hr Who We Are: Orb Health's Enterprise Virtual Care™ enables the ... In this role the Care Management (LVN, LPN, or RN) will be responsible for providing telephonic ...
Chronic Care Management LVN - REMOTE (California License Required)
Los Angeles, CA · On-site +1
$25/hr
*FULL TIME REMOTE POSITION* $25hr Who We Are: Orb Health's Enterprise Virtual Care™ enables the ... In this role the Care Management (LVN, LPN, or RN) will be responsible for providing telephonic ...
California - Ability to work remote, but ideal candidate will reside in the state of California. This position requires California RN Licensure. Candidates must have significant IPA delegation ...
California - Ability to work remote, but ideal candidate will reside in the state of California. This position requires California RN Licensure. Candidates must have significant IPA delegation ...
RN Director, Healthcare Services (Remote in California)
Long Beach, CA · Remote
$101K - $198K/yr
California - Ability to work remote, but ideal candidate will reside in the state of California. This position requires California RN Licensure. Candidates must have significant IPA delegation ...
RN Director, Healthcare Services (Remote in California)
Long Beach, CA · Remote
$101K - $198K/yr
California - Ability to work remote, but ideal candidate will reside in the state of California. This position requires California RN Licensure. Candidates must have significant IPA delegation ...
RN Director, Healthcare Services (Remote in California)
Los Angeles, CA · Remote
$101K - $198K/yr
California - Ability to work remote, but ideal candidate will reside in the state of California. This position requires California RN Licensure. Candidates must have significant IPA delegation ...
New
RN Director, Healthcare Services (Remote in California)
Los Angeles, CA · Remote
$101K - $198K/yr
California - Ability to work remote, but ideal candidate will reside in the state of California. This position requires California RN Licensure. Candidates must have significant IPA delegation ...
New
Care Review Clinician (RN) Remote (Must Reside In AZ)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ... Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ...
Care Review Clinician (RN) Remote (Must Reside In AZ)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ... Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ...
Care Manager, LTSS (RN) Remote (Detroit MI)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This RN will act as a Care Coordinator (Long Term Care Services) supporting our Medicaid and ... This is a remote position with substantial field work and productivity is important. Preferred ...
Care Manager, LTSS (RN) Remote (Detroit MI)
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This RN will act as a Care Coordinator (Long Term Care Services) supporting our Medicaid and ... This is a remote position with substantial field work and productivity is important. Preferred ...
Care Review Clinician (RN) Remote (AZ)
Long Beach, CA · Remote
$26.41 - $51.49/hr
We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ... Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ...
Care Review Clinician (RN) Remote (AZ)
Long Beach, CA · Remote
$26.41 - $51.49/hr
We are seeking a candidate with an Arizona RN licensure. The ideal candidate will have experience ... Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ...
RN Case Manager - Managed Care REMOTE
Los Angeles, CA · Remote
$39 - $41/hr
Registered Nurse (RN) Disease Manager Job Overview : The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or ...
Quick apply
RN Case Manager - Managed Care REMOTE
Los Angeles, CA · Remote
$39 - $41/hr
Registered Nurse (RN) Disease Manager Job Overview : The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or ...
This position will offer remote work flexibility, but the selected candidate must reside in Michigan. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid ...
This position will offer remote work flexibility, but the selected candidate must reside in Michigan. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid ...
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Long Beach, CA · On-site +1
$27.59 - $56.63/hr
This position will offer remote work flexibility, but the selected candidate must reside in Michigan. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid ...
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Long Beach, CA · On-site +1
$27.59 - $56.63/hr
This position will offer remote work flexibility, but the selected candidate must reside in Michigan. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid ...
Remote Rn information
What are some common challenges remote RNs face and how can they overcome them?
What is the difference between Remote Rn vs Remote Lpn?
| Aspect | Remote Rn | Remote Lpn |
|---|---|---|
| Required Credentials | Registered Nurse (RN) license, BSN often preferred | Licensed Practical Nurse (LPN) license |
| Work Environment | Hospitals, clinics, telehealth platforms | Long-term care, home health, telehealth |
| Employer & Industry Usage | Hospitals, healthcare providers, telehealth companies | Long-term care facilities, home health agencies |
Remote Rns typically hold a registered nurse license and work in hospitals or telehealth settings, providing comprehensive patient care. Remote Lpns, with a practical nurse license, often work in long-term care or home health. While both roles involve remote patient interaction, Rns usually handle more complex cases, whereas Lpns focus on basic patient care tasks.
What are the key skills and qualifications needed to thrive as a Remote RN, and why are they important?
What is the best remote job for a nurse?
How can I make 2000 a week working from home?
How to Become a Remote RN
To become a remote nurse, you need the same training, education, and qualifications that non-remote nurses possess, namely nursing licensure in your state. Some virtual RN roles may also require some period of on-site training to learn procedures. Since your duties include performing patient triage via telephone, webcam, or chat apps, you also need strong technical skills and a high-speed internet connection. Fluency in more than one language is a big plus, as is a strong track record of success in self-directed roles. Additionally, a variety of telehealth certifications are available, and these increase your appeal with potential employers.
How to make 300,000 as a nurse online?
What are Remote RNs?
How to make an extra $2000 a month as a nurse?

Full-time
Posted 24 days ago
Molina Healthcare rating
8.0
Based on 196 frontline employees who took The Breakroom Quiz
160th of 298 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
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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.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Long Beach, CA, US
Year founded
1980