Molina Healthcare

Remote Care Review Clinician

Molina Healthcare

Remote
Full-TimeDepends on ExperienceSenior LevelMasters
Job Description

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:

  1. Coordinate and provide quality management/utilization management reviews to ensure members’ access to quality healthcare services.
  2. Conduct reviews to ensure that services are provided in accordance with the Molina Healthcare policies and procedures.
  3. Provide quality healthcare services to members through the review of services.
  4. Interact with members and providers.
  5. Maintain a current, active, unrestricted clinical license in the state of practice.
  6. Maintain a minimum of two (2) years of clinical experience in an acute care setting.
  7. Maintain a minimum of two (2) years of quality management/utilization management experience in a managed care organization.
  8. Adhere to Molina Healthcare policies and procedures.
Where is this job?
This job opening is listed as 100% remote
Job Qualifications
  • Ability To Work Independently

  • Excellent Problem Solving And Communication Skills

  • Attention To Detail And Accuracy

  • Clinical License (Eg. Rn

  • Lpn

  • Pa)

  • Knowledge Of Healthcare Industry And Payer Processes

  • Ability To Work With A Variety Of Technology

  • Proficiency With Computer And Internet Applications

  • Knowledge Of Health Care Laws And Regulations

Required Skills
  • Documentation

  • Quality Assurance

  • Data Entry

  • Communication

  • Problem Solving

  • Critical Thinking

  • Medical Terminology

  • Record keeping

  • Medical coding

  • Patient assessment

  • Care Coordination

  • Healthcare Services

  • Healthcare Regulations

  • Remote Care

  • Healthcare Information

Soft Skills
  • Communication

  • Conflict Resolution

  • Leadership

  • Negotiation

  • Problem Solving

  • Time management

  • Interpersonal Skills

  • creativity

  • Teamwork

  • Adaptability

Compensation

According to JobzMall, the average salary range for a Remote Care Review Clinician is between $55,000 and $75,000 per year. The salary range varies depending on the experience and qualifications of the individual, the company they are working for, and the location of the job. Additionally, factors such as benefits packages, bonuses, and other incentives may also affect the salary range for this position.

Additional Information
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.
Required LanguagesEnglish
Job PostedNovember 28th, 2023
Apply BeforeMay 22nd, 2025
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About Molina Healthcare

Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.

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