Student Veterans of America Jobs

Welcome to SVA’s jobs portal, your one-stop shop for finding the most up to date source of employment opportunities. We have partnered with the National Labor Exchange to provide you this information. You may be looking for part-time employment to supplement your income while you are in school. You might be looking for an internship to add experience to your resume. And you may be completing your training ready to start a new career. This site has all of those types of jobs.

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  • Jobs on this site are original and unduplicated and come from three sources: the Federal government, state workforce agency job banks, and corporate career websites. All jobs are vetted to ensure there are no scams, training schemes, or phishing.
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  • The newest jobs are listed first, so use the search features to match your interests. You can look for jobs in a specific geographical location, by title or keyword, or you can use the military crosswalk. You may want to do something different from your military career, but you undoubtedly have skills from that occupation that match to a civilian job.
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Job Information

Molina Healthcare Care Review Clinician, Prior Auth (RN) in Idaho

JOB 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

  • Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.

  • Analyzes clinical service requests from members or providers against evidence based clinical guidelines.

  • Identifies appropriate benefits and eligibility for requested treatments and/or procedures.

  • Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and its members.

  • Processes requests within required timelines.

  • Refers appropriate prior authorization requests to Medical Directors.

  • Requests additional information from members or providers in consistent and efficient manner.

  • Makes appropriate referrals to other clinical programs.

  • Collaborates with multidisciplinary teams to promote Molina Care Model

  • Adheres to UM policies and procedures.

  • Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.

  • Must be able to travel within applicable state or locality with reliable transportation as required for internal meetings.

JOB QUALIFICATIONS

Required Education

Completion of an accredited Registered Nurse (RN).

Required Experience

1-3 years of hospital or medical clinic experience.

Required License, Certification, Association

Active, unrestricted State Registered Nursing (RN) license in good standing.

Preferred Experience

Previous experience in hospital Acute care, ER or ICU

Previous experience with InterQual or MCG guidelines

Work schedule: Mon - Fri / Sun - Thurs / Tues - Sat daytime hours, some weekends and holidays required for all shifts.

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: $26.41 - $61.79 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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