Care Review Clinician, Inpatient Review (RN) NIGHT SHIFT (CALIFORNIA HOURS)
Los Angeles, California
Employer: Molina Healthcare
Industry:
Salary: $23.76 - $51.49 per hour
Job type: Full-Time
NIGHT SHIFT WORK SCHEDULE:
PERMANENT SHIFT WILL BE A 12 hour NIGHT SHIFT: 7:30PM (in the evening) - 08:30AM (in the morning) PACIFIC HOURS , 3 days a week will rotate. This department runs 24 / 7 / 365 days a year. Rotating weekends and holidays will be required. Candidates can live anywhere if they have a valid CALIFORNIA RN license and are available for the shift hours as posted. Out of state candidates will need to work PACIFIC HOURS. Please consider this requirement before applying to this position.
TRAINING SCHEDULE WILL BE Monday thru Friday 8:30AM to 5:30PM PACIFIC throughout a 2 - 3 month training and then will move to a 3 day/12 hour shift from then on.
Previous experience with Utilization Management / Utilization Review is very essential to this role. Experience with Case Management is a plus.
This is a remote role (work from home). Excellent computer multi-tasking skills and analytical thought process is important to be successful in this role. Home office with high speed internet connectivity required. Productivity is important with turnaround times. Further details to be discussed during our interview process.
JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
KNOWLEDGE/SKILLS/ABILITIES
JOB QUALIFICATIONS
Required Education
Graduate from an Accredited School of Nursing.
Required Experience
3+ years hospital acute care/medical experience.
Required License, Certification, Association
Active, unrestricted State Registered Nursing (RN) license in good standing.
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
Preferred Education
Bachelor's Degree in Nursing
Preferred Experience
Recent hospital experience in ICU, Medical, or ER unit.
Preferred License, Certification, Association
Active, unrestricted Utilization Management Certification (CPHM).
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $23.76 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time
Posting Date: 02/19/2024
PERMANENT SHIFT WILL BE A 12 hour NIGHT SHIFT: 7:30PM (in the evening) - 08:30AM (in the morning) PACIFIC HOURS , 3 days a week will rotate. This department runs 24 / 7 / 365 days a year. Rotating weekends and holidays will be required. Candidates can live anywhere if they have a valid CALIFORNIA RN license and are available for the shift hours as posted. Out of state candidates will need to work PACIFIC HOURS. Please consider this requirement before applying to this position.
TRAINING SCHEDULE WILL BE Monday thru Friday 8:30AM to 5:30PM PACIFIC throughout a 2 - 3 month training and then will move to a 3 day/12 hour shift from then on.
Previous experience with Utilization Management / Utilization Review is very essential to this role. Experience with Case Management is a plus.
This is a remote role (work from home). Excellent computer multi-tasking skills and analytical thought process is important to be successful in this role. Home office with high speed internet connectivity required. Productivity is important with turnaround times. Further details to be discussed during our interview process.
JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
KNOWLEDGE/SKILLS/ABILITIES
- Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
- Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
- Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
- Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed.
- Processes requests within required timelines.
- Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner.
- Requests additional information from members or providers in consistent and efficient manner.
- Makes appropriate referrals to other clinical programs.
- Collaborates with multidisciplinary teams to promote Molina Care Model.
- Adheres to UM policies and procedures.
- Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.
JOB QUALIFICATIONS
Required Education
Graduate from an Accredited School of Nursing.
Required Experience
3+ years hospital acute care/medical experience.
Required License, Certification, Association
Active, unrestricted State Registered Nursing (RN) license in good standing.
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
Preferred Education
Bachelor's Degree in Nursing
Preferred Experience
Recent hospital experience in ICU, Medical, or ER unit.
Preferred License, Certification, Association
Active, unrestricted Utilization Management Certification (CPHM).
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $23.76 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time
Posting Date: 02/19/2024
Created: 2024-06-22
Reference: 2024600
Country: United States
State: California
City: Los Angeles
ZIP: 90291
Similar jobs:
-
Per Diem HUSC - Emergency Department- Night Shift
UC Irvine Health in Orange, California💸 $27.17 per hour -
Night Shift Telepsychiatrist, Elk Grove, Santa Ana, Rancho Cucamonga, Diamond Bar
State Of California in Bakersfield, California -
Teleradiology Physician (Night Shift)
Dignity Physician Careers in Rancho Cordova, California💸 $188 - $192 per hour -
Nursing Assistant-Med Surg Telemetry (Bldg3)- F/T, Night Shift
UC Irvine Health in Orange, California💸 $20.46 per hour -
Staff Nurse II - ICU Critical Care Part Time Night Shift
Kaiser Permanente in Redwood City, California💸 $81.02 - $96.24 per hour -
Operations Area Manager (night shift)
Precision Castparts Corp. in Valencia, California💸 $125100 - $187700 per year -
Per Diem Nursing Assistant- Medical/Surgical 5T- Night Shift
UC Irvine Health in Orange, California💸 $25.88 per hour -
Staff Nurse II - Labor & Delivery 32 Hour Benefited Night Shift
Kaiser Permanente in Redwood City, California💸 $81.02 - $96.24 per hour -
Night Shift Telepsychiatrist, Elk Grove, Santa Ana, Rancho Cucamonga, Diamond Bar
State Of California in Bakersfield, California -
Emergency Room Assistant - PT- Night Shift - West LA
Kaiser Permanente in Los Angeles, California💸 $27.04 - $29.96 per hour -
Registered Nurse (RN) - Emergency Dept - Full Time Night Shift
UHS in Murrieta, California -
Registered Nurse (RN) - Med/Surg/Tele - Per diem - Night Shift
UHS in Wildomar, California -
Nursing Attendant - Part Time - Night Shift - LAMC
Kaiser Permanente in Los Angeles, California💸 $23.19 - $25.16 per hour -
Clinical Lab Scientist- Microbiology- F/T Night Shift
UC Irvine Health in Orange, California -
Staff Nurse II - Labor & Delivery 28 Hour Benefited Night Shift
Kaiser Permanente in Redwood City, California💸 $81.02 - $96.24 per hour -
Registered Nurse (RN) - Med/Surg/Tele - Per Diem Night Shift
UHS in Murrieta, California -
Patient Care Assistant II - Night Shift - Emergency Department
Rady Children's Hospital-San Diego in San Diego, California -
Warehouse Worker Part Time Flex, Night Shift
Cardinal Health Inc. in Elk Grove, California💸 $21.90 per hour -
Central Sterile Technician I- Sterile Processing- F/T, Night Shift
UC Irvine Health in Orange, California💸 $22.37 per hour -
Process Engineer - Night Shift
Danaher Corporation in Lodi, California