Top 1099 Registered nurse Jobs in Remote *

Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare, Inc. —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare, Inc. —Saint Petersburg, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare, Inc. —Orlando, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Telehealth Triage Registered Nurse (RN)
Lumina Care —Remote
- $38 - $45 an hour
- Weekends as needed
- Remote
- Nursing
- Psychiatry
- RN License
- Paid holidays
- Health insurance
Quick Apply
Registered Nurse (Remote) (0600-1800 EST)
Florida Telehealth Medical Group (FTMG) —Remote
- $36 an hour
- Full-time
- Remote
- Google Workspace
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
Remote Registered Nurse (1200-0000 EST)
Florida Telehealth Medical Group (FTMG) —Remote
- $36 an hour
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
RN Telephonic Nurse - Accredo - Work from Home, Anywhere, USA (Compact Nursing License Required)
The Cigna Group —Remote
- $33 - $56 an hour
- Online Application
- Remote
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
3d
Clinical Medical Review Nurse (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $67,320 - $133,705 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- 401(k)
Quick Apply
10d
HCBA OCM RN Case Manager - San Jose
Libertana —San Jose, CA
- $95,000 - $105,000 a year
- Full-time
- Remote
- Current TB test
- Mid-level
- Residential
Quick Apply
RN Auditor - Telecommute
Grace Care, LLC. —Massachusetts
- $44 - $47 an hour
- Full-time
- Remote
- RN License
- Computer literacy
- Mid-level
- Work from home
Quick Apply
1d
Clinical Documentation Specialist-Remote
Onpoint Healthcare —Remote
- $45 - $55 an hour
- 8 hour shift
- Remote
- RN License
- Hospital
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
[CA] Remote RN Care Manager – Geriatric Care Coordination | up to $60/hr
Hera —California
- $30 - $60 an hour
- Choose your own hours
- Remote
- Nursing
- RN License
- Adults
- Flexible schedule
Quick Apply
Medical Record Review Nurse (RN)-New York Licensed
National Medical Reviews, Inc. —Remote
- $65,000 - $70,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- Employee assistance program
- Flexible schedule
Quick Apply
Registered Nurse - Per Diem
Aarris Healthcare Staffing —Santa Barbara, CA
- Up to $125 an hour
- Per diem
- Remote
- RN License
- HIPAA
- 3 years
- Flexible schedule
Quick Apply
Patient Services Specialist - Telephonic RN
Serva Health LLC —Texas
- From $65,000 a year
- Weekends as needed
- Remote
- Background check
- Spanish
- Nursing
- Health insurance
- Dental insurance
Quick Apply
Telehealth Primary Care Nurse - NY license (RN) - Full Time
RelateCare —Remote
- $29 an hour
- 8 hour shift
- Remote
- Nursing
- RN License
- Primary Care
- Health insurance
- Dental insurance
Quick Apply
Auditor Clinical Validation DRG
Cotiviti —Remote
- $45.67 an hour
- Full-time
- Nursing
- 5 years
- Writing skills
- Paid holidays
- Disability insurance
RN - After Hours (Night Shift)
LifeSpark Group LLC —Saint Louis Park, MN
- $38 - $40 an hour
- Part-time
- Remote
- Nursing
- RN License
- 5 years
Quick Apply
8d
CDI Specialist-2nd Level Reviewer
Onpoint Healthcare —Remote
- $50 - $57 an hour
- Part-time
- Remote
- Anatomy knowledge
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
11d

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registered nurse jobs near remote *

Care Review Clinician (BH Licensed) - Remote in FL

Molina Healthcare, Inc. -
Miami, FL

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Productivity software

Full Job Description

JOB DESCRIPTION Job Summary

Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations, and 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 - ensuring 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 and presents cases 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 Molina care model.
Adheres to utilization management (UM) policies and procedures.
May work collaboratively with appropriate departments to provide applied behavior analysis (ABA)/behavioral health therapy (BHT) services to Molina members with autism spectrum disorder (ASD) and other related disorders.
May approve requests for BHT by reviewing behavioral assessments and treatment plans for medical necessity and BHT best practice guidelines. This includes but is not limited to: psychological evaluation requests, comprehensive diagnostic evaluations, functional behavioral assessments, and progress reports.
May perform ongoing monitoring of BHT treatment plans to evaluate effectiveness and treatment efficacy.
May provide peer to peer consultation BHT in-network providers to support treatment planning and maximize member progress.
May work collaboratively with ABA providers to ensure best service practices for members.
May create and develops forms, recommendations and guidelines and training for BHT service delivery.
May collaborate and coordinate with behavioral health medical directors, and senior medical directors to ensure proper management of the BHT benefit.

Required Qualifications

At least 2 years health care experience, including experience in behavioral health and/or hospital acute care, or equivalent combination of relevant education and experience.
Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT) or equivalent behavioral health licensure. License must be active and unrestricted in state of practice.
May require behavioral analyst experience, and/or board certification/licensure as a behavioral analyst (BCBA and/or LBA).
Demonstrated knowledge of community resources.
Ability to operate proactively and demonstrate detail-oriented work.
Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
Ability to work independently, with minimal supervision and demonstrate self-motivation.
Responsive in all forms of communication, and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
Excellent problem-solving, and critical-thinking skills.
Strong verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

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

#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

Refine Your Search

registered nurse jobs in remote *

Care Review Clinician (BH Licensed) - Remote in FL

Care Review Clinician (BH Licensed) - Remote in FL

Care Review Clinician (BH Licensed) - Remote in FL

Care Review Clinician (BH Licensed) - Remote in FL

Telehealth Triage Registered Nurse (RN)

Registered Nurse (Remote) (0600-1800 EST)

Remote Registered Nurse (1200-0000 EST)

RN Telephonic Nurse - Accredo - Work from Home, Anywhere, USA (Compact Nursing License Required)

Clinical Medical Review Nurse (Remote)

HCBA OCM RN Case Manager - San Jose

RN Auditor - Telecommute

Clinical Documentation Specialist-Remote

[CA] Remote RN Care Manager – Geriatric Care Coordination | up to $60/hr

Medical Record Review Nurse (RN)-New York Licensed

Registered Nurse - Per Diem

Patient Services Specialist - Telephonic RN

Telehealth Primary Care Nurse - NY license (RN) - Full Time

Auditor Clinical Validation DRG

RN - After Hours (Night Shift)

CDI Specialist-2nd Level Reviewer

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