Top 27 Rn work from home Jobs in Daly City Ca

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
Molina Healthcare —San Francisco, CA
- $30.37 - $59.21 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Discharge planning
- Health insurance
Registered Nurse
Premier Home Health Providers Inc. —San Francisco, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
14d
Registered Nurse
Caring Hand Home Health Solutions, Inc. —Sausalito, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
6d
Registered Nurse
Madrona Hospice Care Inc. —San Francisco, CA
- $140 - $150 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
14d
Clinical Manager (RN)
Vynca —San Mateo, CA
- $90,000 - $125,000 a year
- Weekends as needed
- Remote
- Background check
- RN License
- Salesforce
- Health insurance
- Dental insurance
Clinical Support Nurse, RN (Temporary)
Sprinter Health —Menlo Park, CA
- Full-time
- Remote
- Nursing
- RN License
- 3 years
Quick Apply
Registered Nurse
Best Home Health Providers, Inc. —San Mateo, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Per diem Hospice Triage Nurse - Remote - MUST HAVE CA RN LICENSE
Mission Hospice and Home Care —San Mateo, CA
- $51.40 - $64.30 an hour
- Per diem
- Remote
- Nursing
- RN License
- Mid-level
Quick Apply

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7d

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rn work from home jobs near daly city ca

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)

Molina Healthcare -
San Francisco, CA

Apply Now

Job Details

Full-time
$30.37 - $59.21 an hour

Benefits

Health insurance

Qualifications

Inpatient experience
RN License
Managed care organization experience
Pre-authorization review for utilization management
Acute care experience
Productivity software
Nursing

Full Job Description

JOB DESCRIPTION Job Summary

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote the Molina care model.
Adheres to utilization management (UM) policies and procedures.

Required Qualifications

At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Strong written and verbal communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications
Certified Professional in Healthcare Management (CPHM).

Utilization review, prior authorization, inpatient review desirable. MCG experience, strongly preferred.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $30.37 - $59.21 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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rn work from home jobs in daly city ca

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)

Registered Nurse

Registered Nurse

Registered Nurse

Clinical Manager (RN)

Clinical Support Nurse, RN (Temporary)

Registered Nurse

Per diem Hospice Triage Nurse - Remote - MUST HAVE CA RN LICENSE

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