[Skip to main content](#main-content) [ OpenNash ](https://opennash.com/) / [Jobs](https://jobs.opennash.com/) [ 01 Search jobs](https://jobs.opennash.com/search/)[ 02 Companies](https://jobs.opennash.com/explore/)[ 03 Hiring report](https://jobs.opennash.com/reports/hiring/)[ 04 AI assistants](https://jobs.opennash.com/connect/)[ 05 How it works](https://jobs.opennash.com/methodology/) Molina Healthcare · United States # Care Review Clinician (RN) - Behavioral Health United States Remote Healthcare & Clinical Listed on Molina Healthcare’s official careers site. Posted October 27, 2026. Check that it is still open and apply there. [Apply on Molina Healthcare’s careers site →](https://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2039900) [OpenNash Jobs](https://jobs.opennash.com/) / [Molina Healthcare](https://jobs.opennash.com/companies/molina-healthcare/) / Care Review Clinician (RN) - Behavioral Health ## Job description BH experience required. Must be licensed in OH or have a compact license. The Care Review Clinician will provide prior authorization for behavioral health services for the OH Medicaid population. Strong behavioral health care experience required (Inpatient Mental Health/Psych, Substance Use Disorder, Rehabilitation/withdrawal management, outpatient BH related services etc). Excellent computer multi-tasking skills and good productivity is essential for this fast-paced role. Good analytical thought process is important to be successful in this role. Prefer candidates that have experience with ASAM, MCG or previous experience with Utilization Reviews. ### WORK SCHEDULE Monday thru Friday 8:00AM to 5:00PM EST (Rotating weekends and Holiday schedules are required for this position.) Once orientation period has finished, Employee may be eligible for an alternative work schedule. This is a remote position. Home office with internet connectivity of high speed required. ### 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 ## At a glance - Posted by the employer: Oct 27, 2026 - First seen by OpenNash: Nov 1, 2026 - Last checked: Nov 8, 2026 - Listed for: 12 days - Location: United States - Work arrangement: Remote[Apply on Molina Healthcare’s careers site →](https://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2039900) ## Hiring at Molina Healthcare - Open jobs: 455 - New in the last 7 days: After two weekly collections - Tracked since: Jul 10, 2026 [All Molina Healthcare jobs](https://jobs.opennash.com/companies/molina-healthcare/) · [Weekly hiring report](/reports/hiring/) ## More jobs at Molina Healthcare ### [Clinical Project Manager](https://jobs.opennash.com/companies/molina-healthcare/jobs/c6df61bf2408165cdb51/) United States ### [Clinical Validation Reviewer, RN - Inpatient Coding & Reimbursement](https://jobs.opennash.com/companies/molina-healthcare/jobs/1d0f136d6a09cf42f05b/) United States ### [Corporate Development Manager (Mergers & Acquisitions) - REMOTE](https://jobs.opennash.com/companies/molina-healthcare/jobs/14229fed8cb499a5806a/) United States ### [Director, Medical Economics - REMOTE](https://jobs.opennash.com/companies/molina-healthcare/jobs/0d32c070494ec29fcc00/) United States ### [Field Care Manager must be located in McLean/Vermillion counties](https://jobs.opennash.com/companies/molina-healthcare/jobs/710f2b39d2843aace89d/) United States ## Similar jobs at other companies ### [Utilization Review Clinician - Behavioral Health](https://jobs.opennash.com/companies/centene/jobs/e94515b02e95c057202c/) Centene · Remote-GA ### [Utilization & Review Clinician (MSW)](https://jobs.opennash.com/companies/universal-health-services/jobs/5af9905fde45830e371e/) Universal Health Services · SACRAMENTO, California ### [Licensed Behavioral Health Clinician - LCSW, LPC or LMFT](https://jobs.opennash.com/companies/unitedhealth-group/jobs/b0610c8d97ebcefd4dc2/) UnitedHealth Group · Bristol, Connecticut ### [Senior Clinician Recruiter - Remote in New England](https://jobs.opennash.com/companies/unitedhealth-group/jobs/b377a5f05dc1cabf3d0e/) UnitedHealth Group · Boston, Massachusetts ### [Licensed Independent Behavioral Health Clinician Case Manager](https://jobs.opennash.com/companies/cvs-health/jobs/e44ddf1a2519c1809b5d/) CVS Health · Work At Home-Pennsylvania [Healthcare & Clinical jobs](/functions/healthcare-clinical/) OpenNash lists jobs from employers’ own careers sites and does not handle applications. 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