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Molina Healthcare · Long Beach, CA

# RN/LVN Care Review Clinician (CA License/PST hours)

Long Beach, CA, United States Healthcare & Clinical 

Listed on Molina Healthcare’s official careers site. Posted October 20, 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/2039638)

[OpenNash Jobs](https://jobs.opennash.com/) / [Molina Healthcare](https://jobs.opennash.com/companies/molina-healthcare/) / RN/LVN Care Review Clinician (CA License/PST hours)

## Job description

### 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 cases 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 health care experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
- Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, 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 a medical unit 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 20, 2026
- First seen by OpenNash: Oct 25, 2026
- Last checked: Nov 1, 2026
- Listed for: 12 days
- Location: Long Beach, CA, United States[Apply on Molina Healthcare’s careers site →](https://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2039638)

## Hiring at Molina Healthcare
- Open jobs: 439
- 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

### [Representative, Care Connections Member Advocate (Bilingual in Spanish, Arabic, Cantonese, Korean, or Tagalog) - Onsite in Long Beach, CA](https://jobs.opennash.com/companies/molina-healthcare/jobs/5a23defae507b11c027c/)

Long Beach, CA, United States

### [Representative, Care Connections Member Advocate - Must Be Bilingual in Spanish (Onsite in Long Beach, CA)](https://jobs.opennash.com/companies/molina-healthcare/jobs/6dadf25ce51c1c0f935a/)

Long Beach, CA, United States

### [Specialist, Health Plan Provider Engagement- (Remote in CA)](https://jobs.opennash.com/companies/molina-healthcare/jobs/ed9cb6e17a6a73517763/)

Long Beach, CA, United States

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