Join Molina Healthcare as an Inpatient Review Clinician (RN) and play a vital role in assessing and coordinating care for members with high needs. Enjoy the flexibility of working from anywhere in the USA while adhering to Pacific Time Zone hours. Leverage your nursing expertise to ensure effective outcomes and compliance in a supportive environment.
Key Responsibilities
Assess inpatient services for optimum outcomes and compliance
Analyze clinical service requests against evidence-based guidelines
Identify appropriate benefits and expected length of stay
Conduct inpatient reviews to determine financial responsibility
Process requests within required timelines
Collaborate with multidisciplinary teams
Make appropriate referrals to other clinical programs
Required Qualifications
Graduate from an Accredited School of Nursing
3+ years hospital acute care/medical experience
Active, unrestricted State Registered Nursing (RN) license in good standing
Valid driver's license with good driving record
Preferred Qualifications
Previous experience in Hospital Acute Care, ER or ICU