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Remote Uas Rn Jobs in Downey, CA (NOW HIRING)

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 ...

Imh

RN Care Manager

West Covina, CA · Remote

$41.20 - $62.17/hr

The RN Hospital Care Manager I delivers comprehensive care management services to designated ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Molina Healthcare

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 ...

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Remote Uas Rn information

What is the difference between Remote Uas Rn vs Remote Uas Nurse?

AspectRemote Uas RnRemote Uas Nurse
CredentialsRegistered Nurse (RN) licenseRegistered Nurse (RN) license
Work EnvironmentRemote healthcare settings, telehealth platformsRemote healthcare settings, telehealth platforms
Industry UsageHealthcare, telemedicineHealthcare, telemedicine
Common Search IntentRemote Uas Rn vs Remote Uas NurseRemote Uas Nurse vs Remote Uas Rn

The roles of Remote Uas Rn and Remote Uas Nurse are similar, both requiring an RN license and working in remote healthcare environments. The main difference lies in terminology preferences; 'Remote Uas Rn' emphasizes the licensing aspect, while 'Remote Uas Nurse' is a more general term. Both positions focus on providing telehealth services, making them highly comparable in industry and work environment.

What are popular job titles related to Remote Uas Rn jobs in Downey, CA? For Remote Uas Rn jobs in Downey, CA, the most frequently searched job titles are:
What job categories do people searching Remote Uas Rn jobs in Downey, CA look for? The top searched job categories for Remote Uas Rn jobs in Downey, CA are:
What cities near Downey, CA are hiring for Remote Uas Rn jobs? Cities near Downey, CA with the most Remote Uas Rn job openings:
Remote Uas Rn jobs near you

Care Review Clinician (RN) Remote

Molina Healthcare

Long Beach, CA • On-site, Remote

$26.41 - $51.49/hr

Full-time

This job post has expired 5 days ago. Applications are no longer accepted.

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 197 frontline employees who took The Breakroom Quiz

163rd of 301 rated insurance

Job description


JOB DESCRIPTION
This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been admitted to this hospital. The Medicaid will support them to ensure a successful transition from inpatient to discharge to either a nursing facility or back to their home. The position is a combination of phone call outreach and in person meetings with the members while still inpatient. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes.
This is a telephonic remote position and productivity is important. Preferred candidates will have previous utilization management, case management, managed care, or inpatient hospital experience. Experience in a behavioral health setting would be a plus.
Schedule: Monday through Friday 8:00AM to 5:00PM EST 8 hours (Weekends, no nights, no call.)
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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