Remote Care Review Clinician

Remote, USA Full-time Posted 2025-03-08

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:
Coordinate and provide quality management/utilization management reviews to ensure members? access to quality healthcare services.
Conduct reviews to ensure that services are provided in accordance with the Molina Healthcare policies and procedures.
Provide quality healthcare services to members through the review of services.
Interact with members and providers.
Maintain a current, active, unrestricted clinical license in the state of practice.
Maintain a minimum of two (2) years of clinical experience in an acute care setting.
Maintain a minimum of two (2) years of quality management/utilization management experience in a managed care organization.
Adhere to Molina Healthcare policies and procedures.

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.

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