RN- Care Review Clinician- Utilization Review (Remote- CA License Req)

{
  "content_hash": "cf24cb4a444eb33ca25e10fc0e9aad184350d5703d544f7345a7ada5a1ab8b37",
  "source_hash": "5d59c3aa0b1eb7495ea0f0c34350f3c21be1d9b3382e72b72c3aedfd04b0f1f4",
  "last_changed_at": "2026-06-06T11:30:43.000Z",
  "active_status": "active"
}

{
  "language": "en",
  "location": {
    "raw": "CA, United States",
    "city": null,
    "region": "CA",
    "country": "United States",
    "is_remote": false,
    "confidence": 0.8
  },
  "salary_max": null,
  "salary_min": null,
  "inferred_at": "2026-06-06T11:30:42.500Z",
  "launch_scope": {
    "reason": "english_us_canada",
    "included": true,
    "language": "en",
    "location": {
      "raw": "CA, United States",
      "city": null,
      "region": "CA",
      "country": "United States",
      "is_remote": false,
      "confidence": 0.8
    },
    "countries": [
      "United States"
    ]
  },
  "remote_policy": "remote",
  "salary_period": null,
  "workplace_type": "remote",
  "salary_currency": null
}

{}

{
  "detail": {
    "Id": "2036930",
    "Title": "RN- Care Review Clinician- Utilization Review (Remote- CA License Req)",
    "media": [],
    "skills": [],
    "JobType": null,
    "Category": "Clinical",
    "JobGrade": null,
    "JobLevel": null,
    "JobShift": null,
    "WorkDays": null,
    "WorkHours": null,
    "WorkYears": null,
    "Department": null,
    "HotJobFlag": false,
    "StudyLevel": null,
    "WorkMonths": null,
    "WorkerType": null,
    "GeographyId": 300000001243005,
    "JobFamilyId": 300000854814201,
    "JobFunction": "Utilization Management",
    "JobSchedule": "Full time",
    "BusinessUnit": null,
    "ContractType": null,
    "Organization": null,
    "TrendingFlag": true,
    "workLocation": [
      {
        "Country": "US",
        "Region1": "LOS ANGELES",
        "Region2": "CA",
        "Region3": null,
        "Building": null,
        "Latitude": "33.76764",
        "Longitude": "-118.19338",
        "LocationId": 100000000335481,
        "PostalCode": "90802",
        "TownOrCity": "Long Beach",
        "AddressLine1": "200 Oceangate",
        "AddressLine2": "Ste 100",
        "AddressLine3": null,
        "AddressLine4": null,
        "LocationName": "Remote Employees"
      }
    ],
    "ContentLocale": "en",
    "HiringManager": null,
    "LegalEmployer": null,
    "RequisitionId": 300002685246596,
    "WorkplaceType": "",
    "BusinessUnitId": 100000000335615,
    "OrganizationId": 300000007437706,
    "GeographyNodeId": 100009205121159,
    "JobFunctionCode": "UTM",
    "LegalEmployerId": 300000007437706,
    "PrimaryLocation": "CA, United States",
    "RequisitionType": "Standard",
    "NumberOfOpenings": null,
    "WorkplaceTypeCode": null,
    "BeFirstToApplyFlag": false,
    "otherWorkLocations": [],
    "secondaryLocations": [
      {
        "Name": "San Francisco, CA, United States",
        "Latitude": "37.77712",
        "Longitude": "-122.41964",
        "CountryCode": "US",
        "GeographyId": 300000001265523,
        "GeographyNodeId": 100009205122359,
        "RequisitionLocationId": 300002686343957
      },
      {
        "Name": "Los Angeles, CA, United States",
        "Latitude": "34.05357",
        "Longitude": "-118.24545",
        "CountryCode": "US",
        "GeographyId": 300000001264710,
        "GeographyNodeId": 100009205122760,
        "RequisitionLocationId": 300002686343958
      },
      {
        "Name": "San Jose, CA, United States",
        "Latitude": "37.33865",
        "Longitude": "-121.88542",
        "CountryCode": "US",
        "GeographyId": 300000001265666,
        "GeographyNodeId": 100009205121967,
        "RequisitionLocationId": 300002686343959
      },
      {
        "Name": "San Diego, CA, United States",
        "Latitude": "32.71568",
        "Longitude": "-117.16171",
        "CountryCode": "US",
        "GeographyId": 300000001265466,
        "GeographyNodeId": 100009205122218,
        "RequisitionLocationId": 300002686343960
      },
      {
        "Name": "Sacramento, CA, United States",
        "Latitude": "38.57944",
        "Longitude": "-121.49085",
        "CountryCode": "US",
        "GeographyId": 300000001265302,
        "GeographyNodeId": 100009205121769,
        "RequisitionLocationId": 300002686343961
      }
    ],
    "ExternalContactName": null,
    "ShortDescriptionStr": "",
    "ExternalContactEmail": null,
    "ExternalPostedEndDate": null,
    "OtherRequisitionTitle": null,
    "requisitionFlexFields": [
      {
        "Value": "$30.37 - $59.21 Hourly *Actual compensation may vary based on geographic location, work experience, education and/or skill level",
        "Prompt": "Salary Range",
        "ControlType": "TextArea",
        "SequenceNumber": 21
      }
    ],
    "ApplyWhenNotPostedFlag": true,
    "DomesticTravelRequired": null,
    "ExternalDescriptionStr": "<p>JOB DESCRIPTION Job Summary</p>\n<p>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.&nbsp;<br><br><strong>Essential Job Duties&nbsp;</strong><br>\n • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.&nbsp;<br>\n • Analyzes clinical service requests from members or providers against evidence based clinical guidelines.&nbsp;<br>\n • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.&nbsp;<br>\n • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.&nbsp;<br>\n • Processes requests within required timelines.&nbsp;<br>\n • Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.&nbsp;<br>\n • Requests additional information from members or providers as needed.&nbsp;<br>\n • Makes appropriate referrals to other clinical programs.&nbsp;<br>\n • Collaborates with multidisciplinary teams to promote the Molina care model.&nbsp;<br>\n • Adheres to utilization management (UM) policies and procedures.&nbsp;<br><br><strong>Required Qualifications&nbsp;</strong><br>\n • 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.&nbsp;<br>\n • Registered Nurse (RN). License must be active and unrestricted in state of practice.&nbsp;<br>\n • Ability to prioritize and manage multiple deadlines.&nbsp;<br>\n • Excellent organizational, problem-solving and critical-thinking skills.&nbsp;<br>\n • Strong written and verbal communication skills.&nbsp;<br>\n • Microsoft Office suite/applicable software program(s) proficiency.&nbsp;<br><br><strong>Preferred Qualifications</strong>&nbsp;<br>\n Certified Professional in Healthcare Management (CPHM).&nbsp;</p>\n<p>Utilization review, prior authorization, inpatient review desirable. MCG experience, strongly preferred.<br><br><br>\n To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.&nbsp;<br><br>\n Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V</p>",
    "ObjectVerNumberProfile": "2",
    "PrimaryLocationCountry": "US",
    "CorporateDescriptionStr": "",
    "ExternalPostedStartDate": "2026-06-04T15:20:38+00:00",
    "ExternalQualificationsStr": "",
    "InternalQualificationsStr": "",
    "OrganizationDescriptionStr": "",
    "primaryLocationCoordinates": [
      {
        "Latitude": "37.71853",
        "Longitude": "-122.09326",
        "CountryCode": "US",
        "GeographyId": 300000001243005,
        "GeographyNodeId": 100009205121159
      }
    ],
    "ExternalResponsibilitiesStr": "",
    "InternalResponsibilitiesStr": "",
    "InternationalTravelRequired": null
  },
  "list_job": {
    "Id": "2036930",
    "Title": "RN- Care Review Clinician- Utilization Review (Remote- CA License Req)",
    "JobType": null,
    "Distance": 1780531200000,
    "JobShift": null,
    "Language": "US",
    "WorkDays": null,
    "JobFamily": null,
    "Relevancy": 10,
    "WorkHours": null,
    "Department": null,
    "HotJobFlag": false,
    "PostedDate": "2026-06-04",
    "StudyLevel": null,
    "WorkerType": null,
    "GeographyId": 300000001243005,
    "JobFunction": null,
    "JobSchedule": null,
    "BusinessUnit": null,
    "ContractType": null,
    "ManagerLevel": null,
    "Organization": null,
    "TrendingFlag": true,
    "workLocation": [
      {
        "Country": "US",
        "Region1": "LOS ANGELES",
        "Region2": "CA",
        "Region3": null,
        "Building": null,
        "Latitude": 33.76764,
        "Longitude": -118.19338,
        "LocationId": 100000000335481,
        "PostalCode": "90802",
        "TownOrCity": "Long Beach",
        "AddressLine1": "200 Oceangate",
        "AddressLine2": "Ste 100",
        "AddressLine3": null,
        "AddressLine4": null,
        "LocationName": "Remote Employees"
      }
    ],
    "LegalEmployer": null,
    "MediaThumbURL": null,
    "WorkplaceType": "",
    "BusinessUnitId": 100000000335615,
    "OrganizationId": 300000007437706,
    "PostingEndDate": null,
    "LegalEmployerId": 300000007437706,
    "PrimaryLocation": "CA, United States",
    "WorkDurationYears": null,
    "WorkplaceTypeCode": null,
    "BeFirstToApplyFlag": false,
    "WorkDurationMonths": null,
    "otherWorkLocations": [],
    "secondaryLocations": [
      {
        "Name": "San Francisco, CA, United States",
        "Latitude": 37.77712,
        "Longitude": -122.41964,
        "CountryCode": "US",
        "GeographyId": 300000001265523,
        "GeographyNodeId": 100009205122359,
        "RequisitionLocationId": 300002686343957
      },
      {
        "Name": "Los Angeles, CA, United States",
        "Latitude": 34.05357,
        "Longitude": -118.24545,
        "CountryCode": "US",
        "GeographyId": 300000001264710,
        "GeographyNodeId": 100009205122760,
        "RequisitionLocationId": 300002686343958
      },
      {
        "Name": "San Jose, CA, United States",
        "Latitude": 37.33865,
        "Longitude": -121.88542,
        "CountryCode": "US",
        "GeographyId": 300000001265666,
        "GeographyNodeId": 100009205121967,
        "RequisitionLocationId": 300002686343959
      },
      {
        "Name": "San Diego, CA, United States",
        "Latitude": 32.71568,
        "Longitude": -117.16171,
        "CountryCode": "US",
        "GeographyId": 300000001265466,
        "GeographyNodeId": 100009205122218,
        "RequisitionLocationId": 300002686343960
      },
      {
        "Name": "Sacramento, CA, United States",
        "Latitude": 38.57944,
        "Longitude": -121.49085,
        "CountryCode": "US",
        "GeographyId": 300000001265302,
        "GeographyNodeId": 100009205121769,
        "RequisitionLocationId": 300002686343961
      }
    ],
    "ShortDescriptionStr": "",
    "requisitionFlexFields": [],
    "DomesticTravelRequired": null,
    "PrimaryLocationCountry": "US",
    "ExternalQualificationsStr": null,
    "ExternalResponsibilitiesStr": null,
    "InternationalTravelRequired": null
  },
  "detail_meta": {
    "url": "https://hckd.fa.us2.oraclecloud.com/hcmRestApi/resources/latest/recruitingCEJobRequisitionDetails?expand=all&onlyData=true&finder=ById;Id=%222036930%22,siteNumber=CX_1",
    "http_status": 200,
    "content_type": "application/json",
    "response_bytes": 7507
  },
  "detail_errors": []
}