Top 47 Remote nurse Jobs in Fremont, Ca

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
Molina Healthcare —San Jose, CA
- $30.37 - $59.21 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Discharge planning
- Health insurance
Clinical Support Nurse, RN (Temporary)
Sprinter Health —Menlo Park, CA
- Full-time
- Remote
- Nursing
- RN License
- 3 years
Quick Apply
Clinical Intake Specialist
Vynca —San Mateo, CA
- $28 - $32 an hour
- Weekends as needed
- Remote
- Background check
- Spanish
- Google Workspace
2d
Oncology RN
Color Health —South San Francisco, CA
- Full-time
- Remote
- Spanish
- Nursing
- 7 years
- Paid parental leave
- Paid holidays
Quick Apply
3d
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 Operations Lead
Lark Health —Mountain View, CA
- $101,230 - $143,540 a year
- Full-time
- Remote
- Nursing
- RN License
- Senior level
Registered Nurse
Premier Home Health Providers Inc. —San Jose, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
LVN Case Manager
Vynca —San Mateo, CA
- $28 - $32 an hour
- Weekends as needed
- Remote
- Background check
- Spanish
- Google Workspace
Registered Nurse
Affinity Hospice Care Inc. —Santa Clara, CA
- $140 - $150 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Registered Nurse - Full or Part time- Contra Costa or Alameda County
One Health Home Health —Livermore, CA
- $60,000 - $180,000 a year
- Weekends as needed
- Remote
- CPR Certification
- Up to 50% travel
- RN License
- COVID-19 protective measures
- Flexible schedule
Quick Apply
Hospice Registered Nurse
Best Hospice Providers Inc. —San Jose, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Pediatric Shift LVN - Santa Clara County
Coastal Kids Home Care —San Jose, CA
- $39 - $42 an hour
- Part-time
- Remote
- Vital signs
- LVN
- HIPAA
Registered Nurse
Best Home Health Providers, Inc. —San Jose, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Registered Nurse
Madrona Hospice Care Inc. —San Jose, CA
- $140 - $150 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Licensed Practical/Vocational Nurse
Affinity Hospice Care Inc. —Alameda, CA
- $50 - $60 a year
- Part-time
- Remote
- CPR Certification
- Nursing
- LVN
- Mileage reimbursement
- Flexible schedule
Quick Apply
Licensed Practical/Vocational Nurse
Madrona Hospice Care Inc. —San Jose, CA
- $50 - $60 a year
- Part-time
- Remote
- CPR Certification
- Nursing
- LVN
- Mileage reimbursement
- Flexible schedule
Quick Apply
Licensed Practical/Vocational Nurse
Best Home Health Providers, Inc. —San Jose, CA
- $45 - $55 a year
- Part-time
- Remote
- CPR Certification
- Nursing
- LVN
- Mileage reimbursement
- Flexible schedule
Quick Apply
Hospice Licensed Practical/Vocational Nurse
Best Hospice Providers Inc. —Santa Clara, CA
- $50 - $60 a year
- Part-time
- Remote
- CPR Certification
- Nursing
- LVN
- Mileage reimbursement
- Flexible schedule
Quick Apply
Registered Nurse - To service Contra Costa County and Alameda county
One Health Home Health —Livermore, CA
- $60,000 - $180,000 a year
- Part-time
- Remote
- CPR Certification
- Up to 50% travel
- RN License
- COVID-19 protective measures
- Flexible schedule
Quick Apply
Registered Nurse (RN), Remote
Carenet Health —United States
- $34 an hour
- Weekends as needed
- Remote
- Bilingual
- Nursing
- RN License
- Continuing education credits
- Paid holidays
4d

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remote nurse jobs near fremont, ca

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

Molina Healthcare -
San Jose, 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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Refine Your Search

remote nurse jobs in fremont, ca

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

Clinical Support Nurse, RN (Temporary)

Clinical Intake Specialist

Oncology RN

Clinical Manager (RN)

Clinical Operations Lead

Registered Nurse

LVN Case Manager

Registered Nurse

Registered Nurse - Full or Part time- Contra Costa or Alameda County

Hospice Registered Nurse

Pediatric Shift LVN - Santa Clara County

Registered Nurse

Registered Nurse

Licensed Practical/Vocational Nurse

Licensed Practical/Vocational Nurse

Licensed Practical/Vocational Nurse

Hospice Licensed Practical/Vocational Nurse

Registered Nurse - To service Contra Costa County and Alameda county

Registered Nurse (RN), Remote

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