Care Review Clinician (RN)

Molina Healthcare is seeking a remote Registered Nurse (RN) to provide clinical member services review and assessment. The role involves verifying medical necessity, assessing services, and facilitating care across the continuum. This position requires experience with appeals, claims review, and medical coding.

Requirements

• Registered Nurse (RN) license active and unrestricted
• Minimum of 2 years of experience, including hospital acute care, inpatient review, prior authorization, or equivalent
• Strong organizational, problem-solving, and critical thinking skills
• Excellent written and verbal communication skills
• Proficiency in Microsoft Office suite

Benefits

• Competitive benefits package
• Equal Opportunity Employer