Urgently Hiring: Remote Care Review Clinician - Quality Management and Utilization Management Specialist in Healthcare
Join the Molina Healthcare Team as a Remote Care Review Clinician: Championing Quality Healthcare Services
Are you a dedicated healthcare professional looking for a new challenge? Do you have a passion for ensuring that patients receive high-quality care? If so, we want to hear from you! Molina Healthcare is seeking a highly skilled and compassionate Remote Care Review Clinician to join our expanding team. As a fully remote role, this position offers the flexibility to work from anywhere, allowing you to balance your work and personal life with ease.
About Molina Healthcare
Molina Healthcare is a leading healthcare organization that provides quality healthcare services to its members. With a strong commitment to diversity, equity, and inclusion, we strive to create an environment where all employees feel valued, respected, and empowered to make a difference. Our mission is to provide high-quality, affordable healthcare to those who need it most, and we are dedicated to achieving this goal through our team of passionate and dedicated healthcare professionals.
Job Summary
As a Remote Care Review Clinician, you will play a critical role in ensuring that our members receive high-quality healthcare services. Your primary responsibility will be to coordinate and provide quality management/utilization management reviews to ensure that services are provided in accordance with Molina Healthcare policies and procedures. You will work closely with members, providers, and other stakeholders to ensure that care is delivered in a timely, effective, and efficient manner.
Key Responsibilities
- Conduct Quality Management/Utilization Management Reviews: Coordinate and provide quality management/utilization management reviews to ensure that members receive high-quality healthcare services.
- Ensure Compliance with Policies and Procedures: Conduct reviews to ensure that services are provided in accordance with Molina Healthcare policies and procedures.
- Interact with Members and Providers: Interact with members and providers to gather information, provide education, and ensure that care is delivered in a patient-centered manner.
- Maintain Current Clinical License and Experience: Maintain a current, active, unrestricted clinical license in the state of practice and a minimum of two (2) years of clinical experience in an acute care setting.
- Utilization Management Experience: 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: Adhere to Molina Healthcare policies and procedures, ensuring that all reviews are conducted in accordance with regulatory requirements and industry standards.
Requirements and Qualifications
To be successful in this role, you will need to possess the following qualifications:
- Current, Active, Unrestricted Clinical License: A current, active, unrestricted clinical license in the state of practice.
- Clinical Experience: A minimum of two (2) years of clinical experience in an acute care setting.
- Quality Management/Utilization Management Experience: A minimum of two (2) years of quality management/utilization management experience in a managed care organization.
- Strong Interpersonal Skills: Strong interpersonal skills, with the ability to interact with members, providers, and other stakeholders.
- Analytical and Critical Thinking Skills: Strong analytical and critical thinking skills, with the ability to analyze complex data and make informed decisions.
Preferred Qualifications
While not required, the following qualifications are preferred:
- Experience with Electronic Health Records: Experience with electronic health records (EHRs) and other healthcare software applications.
- Knowledge of Regulatory Requirements: Knowledge of regulatory requirements and industry standards related to quality management and utilization management.
- Certification in Quality Management: Certification in quality management or a related field.
What We Offer
At Molina Healthcare, we are committed to providing our employees with a comprehensive benefits package, including:
- Competitive Salary: A competitive salary range, commensurate with experience.
- Comprehensive Benefits Package: A comprehensive benefits package, including medical, dental, and vision coverage.
- Retirement Savings Plan: A retirement savings plan, with employer matching contributions.
- Paid Time Off: Paid time off, including vacation, sick leave, and holidays.
- Opportunities for Professional Growth and Development: Opportunities for professional growth and development, including training and education programs.
Work Environment and Culture
At Molina Healthcare, we strive to create a work environment that is inclusive, supportive, and empowering. Our culture is built on the following values:
- Diversity, Equity, and Inclusion: We celebrate diversity and are committed to creating an inclusive environment for all employees.
- Patient-Centered Care: We are dedicated to providing high-quality, patient-centered care to our members.
- Collaboration and Teamwork: We believe in the importance of collaboration and teamwork, and we encourage our employees to work together to achieve common goals.
- Continuous Learning and Improvement: We are committed to continuous learning and improvement, and we encourage our employees to seek out opportunities for growth and development.
Career Growth Opportunities and Learning Benefits
At Molina Healthcare, we are committed to providing our employees with opportunities for career growth and development. We offer a range of training and education programs, including:
- Mentorship Programs: Mentorship programs, designed to help employees develop their skills and achieve their career goals.
- Leadership Development Programs: Leadership development programs, designed to help employees develop their leadership skills and advance in their careers.
- Industry-Specific Training: Industry-specific training, designed to help employees stay up-to-date with the latest developments in healthcare.
Why Join Molina Healthcare?
If you are a dedicated healthcare professional looking for a new challenge, we encourage you to join Molina Healthcare. Here are just a few reasons why:
- Make a Difference: At Molina Healthcare, you will have the opportunity to make a real difference in the lives of our members.
- Collaborative Culture: We have a collaborative culture that values diversity, equity, and inclusion.
- Opportunities for Growth and Development: We offer a range of opportunities for career growth and development, including training and education programs.
- Competitive Benefits Package: We offer a comprehensive benefits package, including medical, dental, and vision coverage.
How to Apply
If you are interested in joining Molina Healthcare as a Remote Care Review Clinician, please submit your application today! We look forward to hearing from you.
Don't hesitate to apply if you don't meet every single requirement. We value a great attitude and a willingness to learn above all.
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