Long Beach, California, United States · Remote Solely
$23/hr–$51/hr
JOB DESCRIPTION **Fully remote opportunity requiring an active Illinois nursing license. The role operates Monday through Friday from 9:30 AM to 6:00 PM CST (30-minute lunch) or 9:00 AM - 6:00 PM CST (1 hour lunch) and r…
Skills: Utilization Management, MCG Guidelines, Clinical Review, Prior Authorization, Medical Necessity Assessment
Long Beach, California, United States · On-site
$22/hr–$25/hr
WelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. We serve the most vulnerable seniors with better quality and compassion in a value-…
Skills: Personal Care, Activities Of Daily Living, Vital Signs Measurement, Patient Transferring, Light Housekeeping
Long Beach, California, United States · Hybrid
$26/hr–$51/hr
JOB DESCRIPTION This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been admitted to this hospital. The Medicaid will support them to ensure a successful transition from inpatien…
Skills: Care Management, Case Management, Patient Assessment, Care Planning, Medication Reconciliation
Long Beach, California, United States · Hybrid
$26/hr–$51/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of …
Skills: Care Management, Care Coordination, Member Assessment, Care Planning, Motivational Interviewing
Long Beach, California, United States · Remote OK
JOB DESCRIPTION Job Summary Provides senior level support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of cont…
Skills: Provider Relations, Network Management, Customer Service, Training And Education, Issue Resolution
Long Beach, California, United States · On-site
Overview Join Healthcare Services Group (HCSG) as a Laundry Worker, where you will play a crucial role in maintaining the cleanliness and availability of linens and garments in a long-term care facility. At HCSG, we are …
Skills: Laundry Operations, Infection Control, Customer Service, Equipment Operation, Sorting
Long Beach, California, United States · On-site
Overview Join Healthcare Services Group (HCSG) as a Housekeeper, where you will play a vital role in maintaining a clean and safe environment in a long-term care facility. At HCSG, we are passionate about positively impa…
Skills: Housekeeping, Sanitation, Infection Control, Customer Service, Safety Guidelines
Long Beach, California, United States · On-site
$23/hr–$51/hr
EST applicants preferred. Ohio licensure required. Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with est…
Skills: Utilization Review, Clinical Assessment, Medical Necessity Verification, Prior Authorization, Case Management
Long Beach, California, United States · On-site
$21/hr–$24/hr
Company Description Dungarvin is seeking dedicated Direct Support Professionals (DSP) to join our Day Program. As a DSP you would coach and foster engagement by leading workshops designed to support individuals with deve…
Skills: Coaching, Mentoring, Behavioral Interventions, Direct Care, Life Skills Training
Long Beach, California, United States · Hybrid
$22/hr–$46/hr
This is a remote field-based role requiring travel. Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team …
Skills: Care Management, Care Coordination, Member Assessment, Care Planning, Waiver Enrollment
Long Beach, California, United States · Hybrid
$22/hr–$46/hr
This is remote field-based role requiring travel. Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team co…
Skills: Care Management, Care Coordination, Member Assessment, Care Planning, Waiver Enrollment
Long Beach, California, United States · Remote OK
$12/hr–$26/hr
JOB DESCRIPTION Job Summary Provides support for pharmacy technician activities. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member…
Skills: Prior Authorization, Pharmacy Technician Activities, Medication Health Care Outcomes, HIPAA Compliance, Microsoft Office
Long Beach, California, United States · Remote OK
$23/hr–$51/hr
JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insura…
Skills: Clinical Review, Utilization Management, Prior Authorization, Medical Necessity Assessment, Case Management
Long Beach, California, United States · Hybrid
$25/hr–$51/hr
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to …
Skills: Care Management, Care Coordination, Comprehensive Assessments, Motivational Interviewing, Medication Reconciliation
Long Beach, California, United States · On-site
JOB DESCRIPTION Opportunity for a Texas licensed RN to join Molina as a Field Care Manager to work with our Medicaid members in the service delivery area around Tyler, TX. You will complete assessments needed for determi…
Skills: Care Management, Member Assessments, Care Planning, Case Coordination, Motivational Interviewing
Long Beach, California, United States · On-site
$88k–$90k/yr
Become an Assistant Administrator for The Chateau of Long Beach! The Chateau of Long Beach is an assisted living facility for the elderly community (ages 59+) located in Long Beach, CA. We are currently looking for an As…
Skills: Facility Management, Staff Management, Regulatory Compliance, Medication Administration, Human Resources
Long Beach, California, United States · On-site
Overview Speech Language Pathologist Overview: Join the Consonus Healthcare team as a Speech Language Pathologist and take your therapy career to new heights! Pacific Palms Healthcare is partnered with Consonus Healthcar…
Skills: Person-Centered Care, Clinical Data Analysis, Care Plan Development, Evidence-Based Practice, Patient Outcome Optimization
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides support for provider network administration activities. Responsible for accurate and timely validation and maintenance of critical provider information on all claims and provider data…
Skills: Provider Network Administration, Claims Processing, Data Entry, Customer Service, Microsoft Office
Long Beach, California, United States · On-site
$18/hr–$21/hr
Become an Assistant Cook for The Chateau of Long Beach! ($500 Sign On Bonus) Schedule needed: Sun-Thurs, 1pm-8:30pm The Chateau of Long Beach is an assisted living facility catered to the elderly community ages (60+) loc…
Skills: Food Preparation, Dietary Management, Texture Modified Food, Food Safety, Risk Management
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides analyst support for configuration oversight activities. Responsible for accurate and timely implementation and maintenance of critical information on claims/provider databases, valida…
Skills: Claims Auditing, Configuration Oversight, Data Analysis, Microsoft Excel, VLOOKUP
Long Beach, California, United States • Remote Solely
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The clinician is responsible for verifying that medical services are necessary and align with clinical guidelines and insurance policies. They analyze service requests and collaborate with multidisciplinary teams to ensure cost-effective member care.
Requires a Registered Nurse (RN) license active in Illinois and at least 2 years of experience in acute care, inpatient review, or managed care. Proficiency in MCG guidelines and utilization management is essential.
JOB DESCRIPTION
Fully remote opportunity requiring an active Illinois nursing license. The role operates Monday through Friday from 9:30 AM to 6:00 PM CST (30-minute lunch) or 9:00 AM - 6:00 PM CST (1 hour lunch) and requires prior experience in Utilization Management (UM) and the application of MCG guidelines. Candidates should be comfortable performing utilization reviews and making clinical determinations based on established criteria.
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.
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
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
Offices: 200 Oceangate, Long Beach, California 90802, US
There are currently 787 open healthcare positions in Long Beach, CA listed on Clera. New openings are added daily as companies post roles.
Companies currently hiring include Molina Healthcare, SCAN, St. Mary Medical Center, TruCare Community, Lorian Health, among others. Browse the listings above to see every active employer.
Yes — 235 of the 787 open healthcare positions offer remote or hybrid work (130 remote, 105 hybrid).
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.
