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HomeCompaniesHckd Fa Us2 Oraclecloud Com CX 1(RN) Care Review Clinician - Weekend Role (REMOTE)

(RN) Care Review Clinician - Weekend Role (REMOTE)

Hckd Fa Us2 Oraclecloud Com CX 1 · KY, United States; Remote Employees, Long Beach, CA, US · Remote · Active · Oracle Recruiting Cloud / Fusion HCM

Job facts

FieldValue
CompanyHckd Fa Us2 Oraclecloud Com CX 1
Title(RN) Care Review Clinician - Weekend Role (REMOTE)
Normalized title-
Department / teamClinical
LocationKY, United States
Work modelRemote / Remote
Employment typeFull Time
Salary-
Statusactive
ATS providerOracle Recruiting Cloud / Fusion HCM
Posted / first seen2026-06-03 / 2026-06-04
Changed / last seen2026-06-04 / 2026-06-06

Related slices

PageWhat it containsOpen
Company jobsActive postings from Hckd Fa Us2 Oraclecloud Com CX 1.Open
Company breakdownsRole, location, ATS, and work model facets for this company.Open
ATS provider jobsActive postings observed through Oracle Recruiting Cloud / Fusion HCM.Open
Provider filtered searchThe same provider as a filtered job collection.Open
Department jobsActive postings in Clinical.Open
Work model jobsActive Remote postings.Open
Lifecycle eventsOpen, update, close, and reopen events for this posting.Open
Original postingCanonical source or apply URL captured from the ATS.Open

Linked records

CompanyHckd Fa Us2 Oraclecloud Com CX 1
Source8214b818-efda-4f30-9713-cac0e888e0f9
ATS providerOracle Recruiting Cloud / Fusion HCM

Description

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. The schedule for this role includes holidays and weekends. 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. 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

Full job record

Job IDe3228686172c5aaa7ed0f34b00559d8d6b776bcc
Org ID6fcfe228-ec8c-4e31-bf8d-2e5d2cb49f0a
Source ID8214b818-efda-4f30-9713-cac0e888e0f9
Board ID8214b818-efda-4f30-9713-cac0e888e0f9
Provideroracle_hcm
Provider Job Key2037520
Title(RN) Care Review Clinician - Weekend Role (REMOTE)
Normalized Title
Statusactive
Activeyes
Location TextKY, United States; Remote Employees, Long Beach, CA, US
DepartmentClinical
Team
Employment Typefull_time
Workplace Typeremote
Remote Policyremote
CountryUnited States
RegionKY
City
Salary RawDescription 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. The schedule for this role includes holidays and weekends. 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. 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
Salary Min
Salary Max
Salary Currency
Salary Period
Source URLhttps://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2037520
Apply URLhttps://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2037520
First Seen At2026-06-04 10:41:54Z
Last Seen At2026-06-06 11:30:43Z
Last Checked At2026-06-06 11:30:43Z
Last Changed At2026-06-04 10:41:54Z
Inactive At
Source Posted At2026-06-03 20:06:32Z
Source Updated At
Raw Payload Uris3://job-postings-prod-raw-590183727216/raw/provider=oracle_hcm/board=hckd.fa.us2.oraclecloud.com|CX_1/date=2026-06-06/2026-06-06T11-30-00-878Z-5a444c553533de92339bc7e174bf6b5a8b1de72b0bf53453749588ed04e6f9bf.json
Event Fields
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  "last_changed_at": "2026-06-04T10:41:54.331Z",
  "active_status": "active"
}
Parsed Structured
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Extensions
{}
Native Structured
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