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Molina Healthcare
This job is no longer accepting applications
See open jobs at Molina Healthcare.See open jobs similar to "UM Care Review Clinician PA MLTC RN Remote in New York" This is CNY.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.
This position will support our Senior Whole Health business. Senior Whole Health by Molina is a Managed Long-Term Care (MLTC)plan. These plans streamline the delivery of long-term services to chronically ill or disabled people who are eligible for Medicaid .We are looking for a RN Care Review Clinician with Prior Authorization experience. Candidates with Utilization Management (UM) and MLTC/LTC experience are highly preferred. Additional experience with appeals, quality review, and experience with data collection/reports. Bilingual candidates that speak Spanish or Mandarin are encouraged to apply.
Work hours: Monday - Friday 8:30AM- 5:00PM EST
Remote position with light travel- 10-15% for in person meeting at the Bronx office location.
KNOWLEDGE/SKILLS/ABILITIES
JOB QUALIFICATIONS
Required Education
Completion of an accredited Registered Nurse (RN).
Required Experience
1-3 years of hospital or medical clinic experience.
MLTC/LTC experience
UM experience
Experience with appeals, quality review, and with data collection/reports
Required License, Certification, Association
Active, unrestricted State Registered Nursing (RN) license in good standing.
NY RN license
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: 07/02/2024This job is no longer accepting applications
See open jobs at Molina Healthcare.See open jobs similar to "UM Care Review Clinician PA MLTC RN Remote in New York" This is CNY.