Care Review Clinician, Inpatient Review (RN) - Remote

Overview

The Care Review Clinician position at Molina Healthcare Services involves assessing, facilitating, planning, and coordinating care for members with high needs, ensuring they receive quality care that is both medically appropriate and cost-effective.

In Short

• Remote position based in Arizona.
• Requires active Arizona RN licensure.
• Experience in Utilization Management and prior authorization is preferred.
• Conducts inpatient reviews and analyzes clinical service requests.
• Collaborates with multidisciplinary teams to ensure optimal patient outcomes.
• Processes requests within required timelines.
• Occasional travel may be required to Molina offices or hospitals.
• Work hours are Monday to Friday, 8:30 AM to 5:00 PM Mountain Time.
• 3+ years of hospital acute care experience required.
• Bachelor's degree in Nursing preferred.

Requirements

• Graduate from an Accredited School of Nursing.
• Active and unrestricted Arizona RN license.
• 3+ years of hospital acute care/medical experience.
• Valid driver's license and good driving record.
• Preferred experience in ICU, Medical, or ER unit.
• Utilization Management/Review experience in Physical and Behavioral Health is preferred.
• Active Utilization Management Certification (CPHM) is preferred.

Benefits

• Competitive benefits and compensation package.
• Equal Opportunity Employer (EOE) M/F/D/V.