Field RN: Facility Site Reviews & Compliance

Molina Healthcare Inc; Chino Hills (CA); Remote; USD 90,000 - 120,000; Full time

Job summary

Molina Healthcare Inc in California seeks a clinical facility reviewer to support site reviews and monitoring of provider programs. Under leadership, you will apply clinical judgement to conduct onsite, virtual, and desk reviews for primary care, specialty, and facility sites while ensuring compliance with local, state, and federal requirements.

This role requires daily out-of-office travel (50–75%) and completion of a DHCS CSR certification within one year.

Qualifications

• At least 2 years of clinical/quality review experience.
• Active and unrestricted RN license in state of practice.
• For California: CSR certification or ability to certify within 1 year.
• Valid driver's license and willingness to travel 50–75%.
• Ability to work across diverse settings and communicate effectively.

Responsibilities

• Conducts onsite, virtual and desktop facility site reviews, medical record reviews, specialty site reviews, PARS, focused reviews, and other reviews as needed.
• Completes all aspects of facility site reviews using applicable regulations and procedures.
• Reviews and audits provider quality programs, processes, and policies.
• Documents discussions and findings in facility site review files.
• Communicates and coordinates information from site visits between leadership, staff and customers.
• Documents review outcomes in designated databases and develops reports.
• Assists with quality interventions documentation and updates.
• Represents Molina as a liaison to address provider questions and concerns.
• Collaborates with providers to support education and compliance efforts.

Skills

Clinical quality review

Communication skills

Microsoft Office

Job description

Molina Healthcare Inc in California seeks a clinical facility reviewer to support site reviews and monitoring of provider programs. Under leadership, you will apply clinical judgement to conduct onsite, virtual, and desk reviews for primary care, specialty, and facility sites while ensuring compliance with local, state, and federal requirements.

This role requires daily out-of-office travel (50–75%) and completion of a DHCS CSR certification within one year.