Care Review Clinician, Inpatient Review (RN) Tues

✨ About The Role

- The position involves assessing inpatient services to ensure optimal outcomes and compliance with regulations.
- The RN will analyze clinical service requests against evidence-based clinical guidelines and determine financial responsibilities.
- Conducting inpatient reviews and prior authorization reviews will be part of the job responsibilities.
- The role requires collaboration with multidisciplinary teams to promote the Molina Care Model and adherence to utilization management policies.
- Occasional travel to other Molina offices or hospitals may be required based on state-specific needs.
                            

⚡ Requirements

- The ideal candidate will have a strong background in nursing, specifically with at least 3 years of experience in hospital acute care settings.
- A registered nurse (RN) license in good standing is essential, along with compact RN licensure to support multiple states.
- Candidates should possess excellent computer skills and attention to detail to manage multiple systems and accurately document interactions.
- Strong communication skills are necessary for effective collaboration with team members and for engaging with members over the phone.
- Flexibility to work in a fast-paced environment, including some weekends and holidays, is crucial for success in this role.
                            

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Care Review Clinician, Inpatient Review (RN) Tues – Sat CENTRAL HOURS - Remote Eligible

Molina Healthcare

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✨ About The Role

⚡ Requirements

Care Review Clinician, Inpatient Review (RN) Tues – Sat CENTRAL HOURS - Remote Eligible

About Molina Healthcare