Top 30 Mds rn Jobs in Remote

Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Orlando, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
(RN) Remote Care Review Clinician - Utilization Review
Molina Healthcare —Daniel Island, SC
- $25.08 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
Molina Healthcare —Los Angeles, CA
- $30.37 - $59.21 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Discharge planning
- Health insurance
Medical Review Nurse - SNF/MDS Auditor
Machinify —Remote
- Remote
- Nursing
- RN License
- HIPAA
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Jacksonville, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
MDS Solutions - Clinical Reimbursement Specialist
MDS Solutions —Madison, WI
- Contract
- Remote
- Nursing
- 5 years
- HIPAA
- Health savings account
- Dental insurance
13d
MDS Solutions - Clinical Reimbursement Specialist
Key Rehabilitation —Minneapolis, MN
- Contract
- Remote
- Nursing
- 5 years
- HIPAA
- Health savings account
- Dental insurance
13d
Remote MDS Nurse - MUST have experience
GC Asset Management LLC —Seneca, MO
- Remote
- Nursing
- Skilled nursing facility
- RN License
6d
Utilization Management Nurse RN
Signature Consulting Services LLC —Louisville, KY
- $75,000 - $82,000 a year
- 8 hour shift
- Remote
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
MDS Coordinator | RN
South Hampton Rehabilitation and Health Care Center —Columbia, MO
- $40 an hour
- Part-time
- Remote
- RN License
- Mid-level
- 1 year
- Paid holidays
- Health insurance
2d
RNAC (PT) | Remote | Must be LOCAL
Corry Manor —Corry, PA
- Part-time
- Remote
- CPR Certification
- Nursing
- RN License
Quick Apply

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Care Review Clinician (RN) - Remote in FL

Molina Healthcare, Inc. -
Florida

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

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

Full Job Description

JOB DESCRIPTION

Must reside in Florida

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).
Recent hospital experience in an intensive care unit (ICU) or emergency room.

Utilization Management (UM) experience highly preferred.

#PJHS3

#LI-AC1

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

Apply Now

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mds rn jobs in remote

Care Review Clinician (RN) - Remote in FL

Care Review Clinician (RN) - Remote in FL

Care Review Clinician (RN) - Remote in FL

(RN) Remote Care Review Clinician - Utilization Review

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

Medical Review Nurse - SNF/MDS Auditor

Care Review Clinician (RN) - Remote in FL

MDS Solutions - Clinical Reimbursement Specialist

MDS Solutions - Clinical Reimbursement Specialist

Remote MDS Nurse - MUST have experience

Utilization Management Nurse RN

MDS Coordinator | RN

RNAC (PT) | Remote | Must be LOCAL

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