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Senior Care Review Processor Jobs (NOW HIRING)

Safe Harbor Home Care

Senior Care Provider

Carlsbad, CA · On-site

$20 - $23/hr

... process: Clearance Verified on the Home Care Aide Registry Current Tuberculosis (TB) certificate ... Registered with state of CA and active HCA number Completed "Criminal Record Statement" (LIC 508 ...

Discovery Institute NJ

Utilization Review

Marlboro, NJ · On-site

Monitor payer portals for authorization updates. * Assist with Medicaid and managed care authorization processes. * Participate in utilization review meetings and case conferences. * Generate reports ...

Horizon Services

Senior Care Coordinator

Tonawanda, NY · On-site

$23.41 - $27/hr

Gain leadership experience by supervising and mentoring interns in the care coordination process ... For further information, please review the Know Your Rights notice from the Department of Labor.

Discovery Institute

Utilization Review

Marlboro, NJ · On-site

Monitor payer portals for authorization updates. * Assist with Medicaid and managed care authorization processes. * Participate in utilization review meetings and case conferences. * Generate reports ...

Discovery Institute NJ

Utilization Review

Marlboro, NJ · On-site

Monitor payer portals for authorization updates. * Assist with Medicaid and managed care authorization processes. * Participate in utilization review meetings and case conferences. * Generate reports ...

Horizon Health

Senior Care Coordinator

Tonawanda, NY

$23.41 - $27/hr

Apply to be a Senior Care Coordinator today! "The best thing about coming to work at Horizon Health ... Gain leadership experience by supervising and mentoring interns in the care coordination process.

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Senior Care Review Processor information

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$30.5K

$64.9K

$87.5K

How much do senior care review processor jobs pay per year?

As of Aug 8, 2026, the average yearly pay for senior care review processor in the United States is $64,909.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,000.00 and $71,500.00 per year, depending on experience, location, and employer.

What is the difference between Senior Care Review Processor vs Care Coordinator?

AspectSenior Care Review ProcessorCare Coordinator
CredentialsTypically requires healthcare or social work certificationsOften requires healthcare, social work, or case management certifications
Work EnvironmentHealthcare facilities, insurance companies, or review agenciesHospitals, clinics, or community health organizations
Employer & IndustryHealthcare and insurance sectorsHealthcare providers and community services
Search & Comparison IntentEvaluating review and processing roles in senior careUnderstanding care coordination roles in healthcare

The Senior Care Review Processor and Care Coordinator roles share similarities in healthcare credentials and work environments. However, the Review Processor focuses on evaluating senior care cases, while the Care Coordinator manages overall patient care plans. Both roles are vital in healthcare settings but serve different functions within the senior care process.

What cities are hiring for Senior Care Review Processor jobs? Cities with the most Senior Care Review Processor job openings:
What are the most commonly searched types of Care Review Processor jobs? The most popular types of Care Review Processor jobs are:
What states have the most Senior Care Review Processor jobs? States with the most job openings for Senior Care Review Processor jobs include:
Senior Care Review Processor jobs near you

Care Review Clinician (RN) Remote

Molina Healthcare

Long Beach, CA

$26.41 - $51.49/hr

Full-time

Posted 28 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 303 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

Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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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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