Care Review Processor
Molina Healthcare Arizona; Tucson, Arizona; Sioux City, Iowa; Louisville, Kentucky; Grand Rapids, Michigan; Rochester, New York; Yonkers, New York; Columbus, Ohio; Orem, Utah; Florida; New Mexico; Washington; Mesa, Arizona; Tampa, Florida; Augusta, Georgia; Macon, Georgia; Boise, Idaho; Iowa City, Iowa; Bellevue, Nebraska; Houston, Texas; Cincinnati, Ohio; Austin, Texas; Fort Worth, Texas; West Valley City, Utah; Bellevue, Washington; Racine, Wisconsin; Nebraska; Ohio; Texas; Wisconsin; Phoenix, Arizona; Covington, Kentucky; Detroit, Michigan; Albuquerque, New Mexico; Salt Lake City, Utah; Green Bay, Wisconsin; Iowa; Miami, Florida; Orlando, Florida; Idaho Falls, Idaho; Bowling Green, Kentucky; Las Cruces, New Mexico; Roswell, New Mexico; Provo, Utah; Georgia; Idaho; Kentucky; Chandler, Arizona; Savannah, Georgia; Des Moines, Iowa; Warren, Michigan; Lincoln, Nebraska; Rio Rancho, New Mexico; Syracuse, New York; Dallas, Texas; Madison, Wisconsin; Jacksonville, Florida; Columbus, Georgia; Davenport, Iowa; Sterling Heights, Michigan; Kearney, Nebraska; Cleveland, Ohio; Akron, Ohio; Dayton, Ohio; Spokane, Washington; Scottsdale, Arizona; Atlanta, Georgia; Caldwell, Idaho; Lexington-Fayette, Kentucky; Owensboro, Kentucky; Omaha, Nebraska; New York, New York; San Antonio, Texas; Layton, Utah; Seattle, Washington; Tacoma, Washington; Vancouver, Washington; Milwaukee, Wisconsin; Kenosha, Wisconsin; New York; Meridian, Idaho; Ann Arbor, Michigan; Grand Island, Nebraska; Santa Fe, New Mexico; Buffalo, New York; Michigan; Utah; St. Petersburg, Florida; Nampa, Idaho; Cedar Rapids, Iowa Job ID 2029265JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
KNOWLEDGE/SKILLS/ABILITIES
- Provides telephone, clerical, and data entry support for the Care Review team.
- Provides computer entries of authorization request/provider inquiries, such as eligibility and benefits verification, provider contracting status, diagnosis and treatment requests, coordination of benefits status determination, hospital census information regarding admissions and discharges, and billing codes.
- Responds to requests for authorization of services submitted via phone, fax, and mail according to Molina operational timeframes.
- Contacts physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director.
Job Qualifications
Required Education
HS Diploma or GED
Required Experience
1-3 years’ experience in an administrative support role in healthcare.
Preferred Education
Associate degree
Preferred Experience
3+ years’ experience in an administrative support role in healthcare, Medical Assistant preferred.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $31.71 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 12/10/2024ABOUT OUR LOCATION
View Map- Inpatient Review (RN): Remote, CALIFORNIA ( 3-12 hour / night shift ) California City California, Columbus Georgia, Davenport Iowa, Lincoln Nebraska, Kenosha Wisconsin, Salt Lake City Utah, Ohio, Washington, Wisconsin, Tucson Arizona, Tampa Florida, Lexington-Fayette Kentucky, Las Cruces New Mexico, Spokane Washington, West Valley City Utah, Idaho, Kentucky, New York, Texas, Chandler Arizona, Meridian Idaho, Des Moines Iowa, Cedar Rapids Iowa, Grand Rapids Michigan, Seattle Washington, Rio Rancho New Mexico, Rochester New York, Green Bay Wisconsin, Cincinnati Ohio, Dallas Texas, Orem Utah, Georgia, Michigan, Phoenix Arizona, Scottsdale Arizona, Miami Florida, St. Petersburg Florida, Idaho Falls Idaho, Sioux City Iowa, Louisville Kentucky, Santa Fe New Mexico, Vancouver Washington, New York New York, Florida, Orlando Florida, Caldwell Idaho, Owensboro Kentucky, Tacoma Washington, Milwaukee Wisconsin, Madison Wisconsin, Dayton Ohio, Houston Texas, Utah, Nebraska, Savannah Georgia, Boise Idaho, Grand Island Nebraska, Roswell New Mexico, Bellevue Washington, Provo Utah, Iowa, Jacksonville Florida, Macon Georgia, Detroit Michigan, Omaha Nebraska, Kearney Nebraska, Buffalo New York, Columbus Ohio, San Antonio Texas, Cleveland Ohio, Fort Worth Texas, New Mexico, Mesa Arizona, Nampa Idaho, Iowa City Iowa, Bowling Green Kentucky, Covington Kentucky, Warren Michigan, Sterling Heights Michigan, Bellevue Nebraska, Yonkers New York, Syracuse New York, Racine Wisconsin, Layton Utah 02/12/2025
- Program Manager, PMO - Health Plan Integrations Arizona, Kearney Nebraska, Las Cruces New Mexico, Rio Rancho New Mexico, Syracuse New York, Akron Ohio, Austin Texas, Green Bay Wisconsin, Kenosha Wisconsin, Tucson Arizona, Scottsdale Arizona, Jacksonville Florida, Boise Idaho, Lincoln Nebraska, Bellevue Nebraska, Grand Island Nebraska, Georgia, Iowa, New York, Dayton Ohio, Texas, Fort Worth Texas, Orem Utah, Orlando Florida, St. Petersburg Florida, Nampa Idaho, Louisville Kentucky, Covington Kentucky, Ann Arbor Michigan, Buffalo New York, Yonkers New York, Nebraska, New Mexico, Houston Texas, Provo Utah, Layton Utah, Spokane Washington, Bellevue Washington, Phoenix Arizona, Chandler Arizona, Idaho Falls Idaho, Sterling Heights Michigan, Albuquerque New Mexico, Dallas Texas, Madison Wisconsin, Augusta Georgia, Savannah Georgia, Davenport Iowa, Caldwell Idaho, Owensboro Kentucky, Detroit Michigan, Roswell New Mexico, Rochester New York, Columbus Ohio, Ohio, Wisconsin, Salt Lake City Utah, Milwaukee Wisconsin, Columbus Georgia, Cedar Rapids Iowa, Iowa City Iowa, Bowling Green Kentucky, Florida, Kentucky, West Valley City Utah, Tacoma Washington, Racine Wisconsin, Mesa Arizona, Meridian Idaho, Sioux City Iowa, Omaha Nebraska, Santa Fe New Mexico, New York New York, Idaho, Cincinnati Ohio, Washington, Vancouver Washington, Miami Florida, Grand Rapids Michigan, Warren Michigan, Cleveland Ohio, Michigan, San Antonio Texas, Utah, Tampa Florida, Atlanta Georgia, Macon Georgia, Des Moines Iowa, Lexington-Fayette Kentucky 02/18/2025
- Manager, Process Improvement (Medicare/ Six Sigma Black Belt) - REMOTE Arizona, St. Petersburg Florida, Racine Wisconsin, Caldwell Idaho, Cleveland Ohio, West Valley City Utah, Rochester New York, Detroit Michigan, Layton Utah, Sterling Heights Michigan, Grand Island Nebraska, Buffalo New York, Lexington-Fayette Kentucky, Augusta Georgia, Louisville Kentucky, Tucson Arizona, Syracuse New York, Green Bay Wisconsin, Bellevue Washington, Salt Lake City Utah, Yonkers New York, Kearney Nebraska, Rio Rancho New Mexico, Columbus Ohio, Omaha Nebraska, Madison Wisconsin, Albuquerque New Mexico, Dallas Texas, Dayton Ohio, Florida, New York, Texas, Wisconsin, Fort Worth Texas, Cincinnati Ohio, Milwaukee Wisconsin, Idaho, Nebraska, New Mexico, Utah, Iowa, Kentucky, Michigan, Georgia, Ohio, Washington, Covington Kentucky, Chandler Arizona, New York New York, Columbus Georgia, Meridian Idaho, Des Moines Iowa, Savannah Georgia, Lincoln Nebraska, Cedar Rapids Iowa, Warren Michigan, San Antonio Texas, Davenport Iowa, Macon Georgia, Provo Utah, Las Cruces New Mexico, Santa Fe New Mexico, Owensboro Kentucky, Akron Ohio, Miami Florida, Jacksonville Florida, Long Beach California, Scottsdale Arizona, Ann Arbor Michigan, Orem Utah, Idaho Falls Idaho, Vancouver Washington, Grand Rapids Michigan, Houston Texas, Kenosha Wisconsin, Austin Texas, Orlando Florida, Nampa Idaho, Boise Idaho, Bowling Green Kentucky, Roswell New Mexico, Spokane Washington, Iowa City Iowa, Phoenix Arizona, Seattle Washington, Tacoma Washington, Atlanta Georgia, Mesa Arizona, Sioux City Iowa, Tampa Florida, Bellevue Nebraska 11/27/2024
- Sr Actuarial Analyst (Marketplace) - REMOTE Arizona, Yonkers New York, Dallas Texas, Austin Texas, Tampa Florida, New York, Macon Georgia, Idaho Falls Idaho, Des Moines Iowa, Davenport Iowa, Sterling Heights Michigan, Lincoln Nebraska, Grand Island Nebraska, Dayton Ohio, Layton Utah, Mesa Arizona, Jacksonville Florida, Washington, Bowling Green Kentucky, New York New York, Cleveland Ohio, Fort Worth Texas, Salt Lake City Utah, Provo Utah, Orem Utah, Tacoma Washington, Scottsdale Arizona, New Mexico, Ohio, Utah, Orlando Florida, Meridian Idaho, Owensboro Kentucky, Detroit Michigan, Warren Michigan, Kearney Nebraska, Santa Fe New Mexico, Buffalo New York, Syracuse New York, Akron Ohio, Seattle Washington, Vancouver Washington, Bellevue Washington, Green Bay Wisconsin, Racine Wisconsin, Miami Florida, Augusta Georgia, Savannah Georgia, Iowa City Iowa, Louisville Kentucky, Omaha Nebraska, Tucson Arizona, Texas, Atlanta Georgia, Wisconsin, Covington Kentucky, Florida, Boise Idaho, Sioux City Iowa, Ann Arbor Michigan, Columbus Ohio, Lexington-Fayette Kentucky, Cincinnati Ohio, Kenosha Wisconsin, Grand Rapids Michigan, Roswell New Mexico, Idaho, Iowa, Rochester New York, Kentucky, Michigan, San Antonio Texas, Milwaukee Wisconsin, Chandler Arizona, St. Petersburg Florida, Columbus Georgia, Nampa Idaho, Cedar Rapids Iowa, Caldwell Idaho, Las Cruces New Mexico, Houston Texas, West Valley City Utah, Spokane Washington, Bellevue Nebraska, Albuquerque New Mexico, Madison Wisconsin, Phoenix Arizona, Georgia, Rio Rancho New Mexico, Nebraska 01/06/2025