See all roles

Remote Care Review Clinician

Work from home Full-time role Hiring

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 Job!

You might like

Outbound Customer Service Representative

Work from home Full-time role

Remote Call Center/Outbound Sales

Work from home Full-time role

Work From Home Receptionist

Work from home Full-time role

Software Engineer II, Google.org

Work from home Full-time role

Remote Executive Virtual Assistant

Work from home Full-time role

Customer Service Support Rep

Work from home Full-time role

Sr. Account Executive, Enterprise

Work from home Full-time role

Remote Medical Billing Specialist

Work from home Full-time role

Sr. Business Development Executive

Work from home Full-time role

Professional Services Systems Engineer

Work from home Full-time role

[FULL TIME Remote] Part Time - REMOTE - Insurance Sales

Work from home Full-time role

Remote Customer Service Chat Specialist – Flexible Schedule, No Phone Calls, $25‑$35/hr – Join arenaflex’s Subscription Skincare Support Team

Work from home Full-time role

Field Sales Manager (m/w/d) – Payment Solutions

Work from home Full-time role

Experienced Night Shift Chat Support Specialist - Flexible Overnight Hours | $25-$35/hr | Remote Work Opportunities

Work from home Full-time role

Motion Designer

Work from home Full-time role

Solutions Engineer

Work from home Full-time role

Architect, Builder Enablement

Work from home Full-time role

Apple Work From.Home Jobs, Apple Remote Entry Level Jobs

Work from home Full-time role

Experienced Remote Chat Support Agent – Public Relations and Customer Service Expert for arenaflex

Work from home Full-time role

REMOTE Sr. Nonprofit Accountant CPA Firm (public accounting exp req)

Work from home Full-time role