Care Review Specialist, Inpatient Assessment

3 weeks ago


Tucson, Arizona, United States Molina Healthcare Full time
Job Overview

Molina Healthcare Services works with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate integrated care delivery across the continuum. Our staff work to ensure patients progress towards desired outcomes with quality care that is medically appropriate and cost-effective.

Job Responsibilities
  1. Assess inpatient services for members to ensure optimum outcomes, cost-effectiveness, and compliance with all state and federal regulations and guidelines.
  2. Analyze clinical service requests from members or providers against evidence-based clinical guidelines.
  3. Identify appropriate benefits, eligibility, and expected length of stay for requested treatments and/or procedures.

Required Skills and 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 a good driving record.

Benefits and Compensation:

  • $26.41 - $61.79 per hour.
  • Competitive benefits package.


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