Remote Care Review Clinician

Remote Full-time
Molina Healthcare is looking for a passionate Remote Care Review Clinician to join our expanding team. As the Remote Care Review Clinician, your primary responsibility will be to coordinate and provide quality management/utilization management reviews to ensure members’ access to quality healthcare services. You will also be responsible for conducting reviews to ensure that services are provided in accordance with the Molina Healthcare policies and procedures.We are searching for an individual with a strong commitment to providing quality healthcare services to members through the review of services. In addition to the strong interpersonal skills and the ability to interact with members and providers, the ideal candidate should possess the following qualifications: a current, active, unrestricted clinical license in the state of practice, a minimum of two (2) years of clinical experience in an acute care setting, and a minimum of two (2) years of quality management/utilization management experience in a managed care organization.If you have a passion for healthcare and are looking for an opportunity to make a difference in people's lives, we want to hear from you!

Responsibilities for the Remote Care Review Clinician:
Coordinate and provide quality management/utilization management reviews to ensure members’ access to quality healthcare services.
Conduct reviews to ensure that services are provided in accordance with the Molina Healthcare policies and procedures.
Provide quality healthcare services to members through the review of services.
Interact with members and providers.
Maintain a current, active, unrestricted clinical license in the state of practice.
Maintain a minimum of two (2) years of clinical experience in an acute care setting.
Maintain a minimum of two (2) years of quality management/utilization management experience in a managed care organization.
Adhere to Molina Healthcare policies and procedures.

Molina Healthcare is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

Apply Now

Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Account Executive

Remote

English to Korean Translator

Remote

[Remote] Account Executive

Remote

Remote Part‑Time Amazon Customer Service Specialist – Home‑Based Support Role with Competitive Compensation

Remote

Advisor, Pharmacy - VIVO Health (Hybrid)

Remote

Apply Now: Driver Merchandiser- El Campo/Victoria, Texas Areas

Remote

Waste Approvals Manager

Remote

Experienced Full Stack Data Entry Clerk – Help Desk Support with Excellent Customer Service Skills for Remote Work Opportunities at Blithequark

Remote

Immediate Hiring: Team Manager - Social Care

Remote

Special Education Teacher - Flexible Virtual Position

Remote
← Back