Emergency Room Admission Nurse Clinician

2 weeks ago


Long Beach, California, United States Molina Healthcare Full time

About the Role:

Molina Healthcare Services (HCS) seeks an experienced Inpatient Review Clinician to join our team. As an integral member of our multidisciplinary team, you will collaborate with healthcare professionals to deliver high-quality, patient-centered care and drive positive patient outcomes.

Main Responsibilities:

  • Assess inpatient services for members to ensure compliance with clinical guidelines, regulatory requirements, and cost-effectiveness.
  • Analyze clinical service requests from members or providers to identify necessary steps for review.
  • Conduct inpatient reviews to determine financial responsibility for Molina Healthcare and its members.
  • Process requests within required timelines, adhering to UM policies and procedures.
  • Maintain accurate and up-to-date records of case activities.

Education and Experience:

  • Graduate from an Accredited School of Nursing.
  • 3+ years of hospital acute care/medical experience.
  • Valid California RN license.

Salary Range:

The estimated hourly salary range for this position is $30.37 - $59.21, representing a competitive offer from Molina Healthcare.

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