Care Review Processor (PST or CST Hours)

Molina Healthcare • Des Moines, IA • 3h ago

Molina Healthcare is hiring several Care Review Processors. These roles are remote and can be worked in a variety of states within the US.

Highly qualified candidates will have the following:

Healthcare knowledge or background either clinical (Medical Assistant) or in an administrative capacity

Experience working in a fast paced, high-volume environment with priorities that may change

High level critical thinking skills

Above average computer skills

Adaptability and attention to detail

Ability to work either 830am-530 pm Monday through Friday or Tuesday through Saturday.

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.

Required Education : HS Diploma or GED

Preferred Education : Associate Degree

Required Experience : 1-3 years' experience in an administrative support role in healthcare.

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 competitive benefits and compensation packages. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Same Posting Description for Internal and External Candidates

Pay Range: $21.16 - $31.71 / HOURLY

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

Similar Jobs

Part Sales Manager - Full Time

AutoZone, Inc. • Waukee, IA • 2h ago

Management & Administrative

Job Description AutoZone's Store Management team drives store performance, fosters a productive team, and ensures exceptional customer service. Managers and MITs play a key leadership role, expected to Live The Pledge an...

2h ago

Go to Apply

NetSuite Sales Account Manager - Denver

Oracle • Des Moines, IA • 2h ago

Management & Administrative

Job Description About Oracle NetSuite Founded in 1998, Oracle NetSuite was the first cloud company - ushering in the new era of cloud computing. NetSuite's mission is to deliver one system, the suite, that gives leaders...

2h ago

Go to Apply

Principal Software Engineer

Oracle • Des Moines, IA • 3h ago

IT & Engineering

Job Description Oracle Health Application and Infrastructure is a new line of business that strives to apply our expertise in IaaS and SaaS to transform the health care industry, provide patient-centric care and make the...

3h ago

Go to Apply

Sr. Software Engineer, OCI Software Ecosystem

Oracle • Des Moines, IA • 3h ago

IT & Engineering

Job Description Oracle Cloud Infrastructure (OCI) delivers mission-critical applications for top tier enterprises around the world. Our cloud offers unmatched hyper-scale, multi-tenant services deployed in more than 50 r...

3h ago

Go to Apply

Principal Software Engineer- OCI Software Ecosystem

Oracle • Des Moines, IA • 3h ago

IT & Engineering

3h ago

Go to Apply

Sr. Software Engineer, OCI Software Ecosystem

Oracle • Des Moines, IA • 3h ago

IT & Engineering

3h ago

Go to Apply

Senior Consultant - Oracle Health - Emergency Department

Oracle • Des Moines, IA • 4h ago

Hospital & Medical

Job Description Senior Consultant - Oracle Health - Emergency Department Location: United States Travel: Potentially up to 50% No visa sponsorship is available for this position. Due to the client contract you will be as...

4h ago

Go to Apply

2nd Shift, Welder I (Onsite)

RTX Corporation • West Des Moines, IA • 9h ago

Manufacturing & Warehouse

Date Posted: 2025-09-13 Country: United States of America Location: HIA02: Engine Comp (TFT) - WDM 4th St 811 Fourth Street, West Des Moines, IA, 50265 USA Position Role Type: Onsite U.S. Citizen, U.S. Person, or Immigra...

9h ago

Go to Apply

Data Scientist, Marketing

Confluent • Des Moines, IA • 12h ago

Sales & Marketing

Location: Remote, United States Employment Type: FullTime Location Type: Remote Department Business Technology Compensation: $160.1K - $188.1K - Offers Equity At Confluent, we are committed to providing competitive pay a...

12h ago

Go to Apply

Market Grille Cook

Hy-Vee Food Stores • Ankeny, IA • 12h ago

Retail & Hospitality

Additional Considerations (if any): - At Hy-Vee our people are our strength. We promise "a helpful smile in every aisle" and those smiles can only come from a workforce that is fully engaged and committed to supporting o...

12h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.