Care Review Clinician

Full Time
Remote
Posted
Job description

Job Description:
Title: Care Review Clinician
Location: Remote
Hours: M-F 8 AM to 5 PM CST or T-S 8 AM to 5 PM PST
Pay: $35/HR

Required Skills:

  • Must have a valid RN License in Texas or Compact State License
  • Must have a degree from an accredited Registered Nursing Program
  • Must have 3 years of Utilization Management experience and experience with MCG

Responsibilities:

  • Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.
  • Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care.
  • Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.

#INDPM

Job Type: Full-time

Pay: $35.00 per hour

Benefits:

  • Dental insurance
  • Health insurance
  • Vision insurance

Schedule:

  • 8 hour shift

Experience:

  • Utilization management: 3 years (Required)
  • MCG: 1 year (Required)

License/Certification:

  • Texas or Compact RN License (Required)

Work Location: Remote

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