Molina Healthcare

Care Review Clinician, Inpatient Review

Molina Healthcare

Fort Worth, TX, USA
Full-TimeDepends on ExperienceSenior LevelMasters
Job Description

Are you a compassionate and detail-oriented healthcare professional looking for a rewarding career with a leading managed care organization? Molina Healthcare is seeking a Care Review Clinician for our Inpatient Review team. In this role, you will play a crucial role in ensuring quality and cost-effective care for our members by conducting inpatient reviews and making appropriate recommendations. If you have a strong clinical background and a passion for advocating for patients, we want to hear from you. Join our team and make a difference in the lives of our members.

  1. Conduct inpatient reviews: The Care Review Clinician will be responsible for conducting inpatient reviews for Molina Healthcare members to assess the quality and cost-effectiveness of their care.
  2. Make appropriate recommendations: Based on the findings of the inpatient reviews, the Care Review Clinician will be responsible for making appropriate recommendations to ensure the best possible care for our members.
  3. Ensure quality and cost-effective care: The primary responsibility of the Care Review Clinician is to ensure that our members receive high-quality, cost-effective care by conducting thorough reviews and making informed recommendations.
  4. Advocate for patients: As a healthcare professional, the Care Review Clinician will be expected to have a strong passion for advocating for patients and ensuring they receive the best possible care.
  5. Utilize clinical knowledge: This role requires a strong clinical background, and the Care Review Clinician will be responsible for utilizing their knowledge and expertise to conduct thorough reviews and make informed recommendations.
  6. Collaborate with multidisciplinary teams: The Care Review Clinician will work closely with other members of the healthcare team, including physicians, nurses, and case managers, to ensure comprehensive and coordinated care for our members.
  7. Keep accurate records: It is essential for the Care Review Clinician to maintain accurate and detailed records of all inpatient reviews and recommendations made to ensure proper documentation of member care.
  8. Stay up-to-date on industry standards: The healthcare industry is constantly evolving, and the Care Review Clinician will be responsible for staying informed and up-to-date on industry standards and best practices to ensure the highest quality of care for our members.
  9. Comply with company policies and procedures: The Care Review Clinician will be expected to adhere to all company policies and procedures, as well as regulatory guidelines, to ensure compliance and the highest level of ethical standards.
  10. Make a difference: This role offers a unique opportunity to make a positive impact on the lives of our members by ensuring they receive the best possible care and
Where is this job?
This job is located at Fort Worth, TX, USA
Job Qualifications
  • Clinical Experience: A Care Review Clinician Should Have At Least 3-5 Years Of Clinical Experience In A Hospital Or Other Healthcare Setting.

  • Knowledge Of Inpatient Care Guidelines: The Ideal Candidate Should Have A Strong Understanding Of Inpatient Care Guidelines And Be Able To Apply Them Effectively In The Review Process.

  • Critical Thinking Skills: A Care Review Clinician Must Possess Excellent Critical Thinking Skills To Assess Patient Needs And Make Appropriate Care Recommendations.

  • Communication Skills: Effective Communication Is Essential In This Role, As The Care Review Clinician Will Be Responsible For Collaborating With Other Healthcare Professionals And Communicating With Patients And Their Families.

  • Detail-Oriented: Inpatient Care Requires Attention To Detail And The Ability To Thoroughly Review Medical Records And Treatment Plans. A Care Review Clinician Should Have Strong Attention To Detail To Ensure Accurate And Comprehensive Reviews.

Required Skills
  • Quality Improvement

  • Case management

  • Patient Advocacy

  • Medical Documentation

  • Behavioral Health

  • Care Coordination

  • Clinical Assessment

  • Utilization Review

  • Medicare/Medicaid Regulations

  • Chronic

  • Interdisciplinary Team Collaboration

Soft Skills
  • Communication

  • Conflict Resolution

  • Emotional Intelligence

  • Leadership

  • creativity

  • flexibility

  • Teamwork

  • Adaptability

  • Problem-Solving

  • Time-Management

Compensation

According to JobzMall, the average salary range for a Care Review Clinician, Inpatient Review in Fort Worth, TX, USA is between $70,000 and $90,000 per year. However, this can vary depending on the specific job responsibilities, experience level, and education of the individual. Factors such as the employer, location, and industry can also impact salary. It is recommended to research the specific company and job listing for a more accurate salary range.

Additional Information
Molina Healthcare is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedFebruary 4th, 2025
Apply BeforeJune 9th, 2026
This job posting is from a verified source. 
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About Molina Healthcare

Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.

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