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REMOTE CARE REVIEW CLINICIAN, INPATIENT REVIEW, CA PACIFIC HOURS

Assess inpatient services to ensure optimum outcomes, cost-effectiveness, and compliance with regulations.
Los Angeles
Senior
$23.76-$51.49 USD per hour
1 week ago
Molina Healthcare

Molina Healthcare

Molina Healthcare is a FORTUNE 500, multi-state health care organization.

1 Similar Job at Molina Healthcare

✨ About The Role

- Conduct inpatient reviews to ensure optimal outcomes, cost-effectiveness, and compliance with regulations and guidelines - Analyze clinical service requests against evidence-based guidelines and determine appropriate benefits and expected length of stay - Process requests within required timelines and make referrals to other clinical programs as needed - Collaborate with Medical Directors and present cases efficiently for review - Adhere to utilization management policies and procedures while promoting the Molina Care Model

⚡ Requirements

- Registered Nurse with at least 5-8 years of experience in acute care, utilization review, and utilization management, preferably in California - Strong analytical skills and ability to multitask effectively in a fast-paced environment - Comfortable working remotely with a dedicated home office setup and high-speed internet connectivity - Willingness to work flexible hours, including weekends and holidays, to meet the demands of the role - Excellent communication skills and the ability to collaborate with multidisciplinary teams to ensure quality care for patients
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REMOTE CARE REVIEW CLINICIAN, INPATIENT REVIEW, CA PACIFIC HOURS
Los Angeles
$23.76-$51.49 USD per hour
Remote
About Molina Healthcare
Molina Healthcare is a FORTUNE 500, multi-state health care organization.