Emergency Room Admissions Review Nurse - Remote

Overview

The Emergency Room Admissions Review Nurse position involves assessing and coordinating care for members with high need potential, ensuring compliance with regulations and guidelines.

In Short

• 2 openings for 12-hour night shifts, 7:30 PM - 8:30 AM Pacific Time.
• Training schedule is Monday to Friday, 8:30 AM to 5:30 PM Pacific for 2-3 months.
• Must have a valid California RN license and work Pacific Time Zone hours.
• Assess inpatient services for optimal outcomes and compliance.
• Analyze clinical service requests against evidence-based guidelines.
• Conduct inpatient reviews to determine financial responsibility.
• Collaborate with multidisciplinary teams to promote care models.
• Occasional travel to other Molina offices or hospitals may be required.
• 3+ years of hospital acute care/medical experience required.
• Active, unrestricted RN license in good standing is mandatory.

Requirements

• Graduate from an Accredited School of Nursing.
• 3+ years of hospital acute care/medical experience.
• Active RN license in California.
• Valid driver's license with a good driving record.
• Bachelor's Degree in Nursing preferred.
• Experience in ER or ICU preferred.
• Familiarity with InterQual or MCG guidelines preferred.

Benefits

• Work with a multidisciplinary team.
• Opportunity to make a significant impact on patient care.
• Flexible work schedule after training.
• Supportive work environment.
• Professional development opportunities.