Top 30 Remote nurse Jobs in Roseville Ca

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
Molina Healthcare —Sacramento, CA
- $30.37 - $59.21 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Discharge planning
- Health insurance
CA Telephonic Case Manager I
CorVel Corporation —Folsom, CA
- $30.64 - $45.80 an hour
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
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CA Medical Case Manager I
CorVel Corporation —Folsom, CA
- $30.64 - $45.80 an hour
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
Quality Assurance Nurse
CorVel Corporation —Folsom, CA
- $61,053 - $98,334 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- Health savings account
- Disability insurance
Quick Apply
11d
Registered Nurse
Premier Home Health Providers Inc. —Loomis, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Registered Nurse
Caring Hand Home Health Solutions, Inc. —El Dorado Hills, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Field Nursing Operations Manager (West Coast)
Science 37 —Sacramento, CA
- Weekends as needed
- Remote
- Nursing
- Vital signs
- RN License
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Licensed Practical/Vocational Nurse
Caring Hand Home Health Solutions, Inc. —El Dorado Hills, CA
- $45 - $55 a year
- Part-time
- Remote
- CPR Certification
- Nursing
- LVN
- Mileage reimbursement
- Flexible schedule
Quick Apply
Licensed Practical/Vocational Nurse
Best Home Health Providers, Inc. —Sacramento, CA
- $45 - $55 a year
- Part-time
- Remote
- CPR Certification
- Nursing
- LVN
- Mileage reimbursement
- Flexible schedule
Quick Apply

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CA Telephonic Case Manager I
CorVel Corporation —Folsom, CA
URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no…
$30.64 - $45.80 an hour
Quick Apply
Ambulatory Nurse Case Manager RN
UC Davis Health —Sacramento, CA
The program aims to develop an effective and cost-efficient system of delivering and managing patient-centered care with a focus on chronic illness requiring…
$71.98 - $105.44 an hour

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Appeals Nurse Consultant (Remote)
CVS Health —Columbus, OH
Must have active and unrestricted RN licensure in state of residence. Qualified applicants with arrest or conviction records will be considered for employment…
$60,522 - $129,615 a year
4d
Clinical Quality Assurance Specialist, RN
Wider Circle —Columbus, OH
An active, unrestricted RN, NP, LPN, or LCSW license (a multi-state or compact license is preferred). You can pull, sort, and understand QA data on your own.
$80,000 - $95,000 a year
Quick Apply

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remote nurse jobs near roseville ca

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

Molina Healthcare -
Sacramento, CA

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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 roseville ca

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

CA Telephonic Case Manager I

CA Medical Case Manager I

Quality Assurance Nurse

Registered Nurse

Registered Nurse

Field Nursing Operations Manager (West Coast)

Licensed Practical/Vocational Nurse

Licensed Practical/Vocational Nurse

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