Care Review Clinician, PA
4 weeks ago
JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
KNOWLEDGE/SKILLS/ABILITIES
- Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
- Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
- Identifies appropriate benefits and eligibility for requested treatments and/or procedures.
- Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and its members.
- Processes requests within required timelines.
- Refers appropriate prior authorization requests to Medical Directors.
- Requests additional information from members or providers in consistent and efficient manner.
- Makes appropriate referrals to other clinical programs.
- Collaborates with multidisciplinary teams to promote Molina Care Model
- Adheres to UM policies and procedures.
- Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.
- Must be able to travel within applicable state or locality with reliable transportation as required for internal meetings.
JOB QUALIFICATIONS
Required Education
Completion of an accredited Registered Nurse (RN).
Required Experience
1-3 years of hospital or medical clinic experience.
Required License, Certification, Association
Active, unrestricted State Registered Nursing (RN) license in good standing.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $23.76 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
-
Care Review Clinician, PA
3 weeks ago
Owensboro, United States DirectEmployers Full time**JOB DESCRIPTION**For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside in. Strong medical and hospital analytical experience is needed. Excellent computer multi-tasking skills and good productivity is essential for this fast-paced role. Strong computer skills, being able to toggle back and forth and use...
-
Lead Clinician
2 weeks ago
Owensboro, United States The Methodist Home of Kentucky, Inc. Full timeLEAD CLINICIAN - CAMINOS PROGRAMDo you have a passion for youth? Do you want to see every child have a bright future? Join the team at the Kentucky United Methodist Children’s Homes (KyUMH). KyUMH has over 150 years of experience serving youth who have experienced trauma. Our vision is to be a preferred provider of services so Kentucky can be a preferred...
-
Owensboro, United States AMN Healthcare Full timeJob Details This facility is seeking anEmergency Medicine Nurse Practitioner or Physician Assistant (NP/PA) for locum tenens support as they look to fill a current need. Details & requirements for this opportunity: &bull Schedule: Start As Soon As Credentialed - Ongoing &bull Job Setting:Level III Trauma,60k annual volume, 10-hour shifts &bull Types of...
-
Owensboro, United States AMN Healthcare Full timeJob Details This facility is seeking anEmergency Medicine Nurse Practitioner or Physician Assistant (NP/PA) for locum tenens support as they look to fill a current need. Details & requirements for this opportunity: &bull Schedule: July start - Ongoing &bull Job Setting:Level III Trauma,60k annual volume, 10-hour shifts &bull Types of Cases:Mostly blunt...
-
Clinical Therapist
4 weeks ago
Owensboro, Kentucky, United States Addiction Recovery Care Full timeAbout the Role:We are seeking a skilled Clinical Therapist to join our team at Addiction Recovery Care, LLC. As a Clinical Therapist, you will be responsible for providing direct patient services, including initial assessments, diagnosis, and documentation of each event necessary to determine placement for level of care.Key Responsibilities:Delivers direct...
-
Cardiologist Opportunity in Owensboro, KY
3 weeks ago
Owensboro, Kentucky, United States Owensboro Health Full timeWe are seeking a highly skilled Non-Invasive Cardiologist to join our team at Owensboro Health Medical Group. As a member of our cardiovascular disease group, you will have the opportunity to work with a team of eight cardiologists and eight Advanced Practice Clinicians (NPs and PAs) in a hospital-employed practice at the Heart Center in Owensboro, KY.The...
-
Clinical Counselor
2 months ago
Owensboro, United States Addiction Recovery Care Full timeAre you looking for the best place to work? Join Addiction Recovery Care, LLC (ARC) which was selected as one of the 2024 Best Places to Work in Kentucky by the Kentucky Chamber of Commerce, based on surveys of our employees!Are you passionate about serving in an environment of shared purpose and shared goals while driving the ARC mission and values to...
-
Cardiac Hospitalist
4 months ago
Owensboro, United States Owensboro Health Full timeJoin a hospital-employed group of nine Cardiologists at the Heart Center in Owensboro, KY. Due to growth, Owensboro Health Medical Group is seeking a Board Certified or Board Eligible Non-invasive Cardiologist to provide inpatient care. In addition, we have eight Advanced Practice Clinicians (NPs and PAs) working closely with our cardiologists. An ideal...
-
Physical Therapist
3 weeks ago
Owensboro, Kentucky, United States Cornerstone Rehab Full timeWe are seeking a skilled Physical Therapist to join our team at Cornerstone Rehab, a clinician-owned and operated company delivering innovative rehab management solutions to skilled nursing facilities in the United States.Key Responsibilities:Provide high-quality physical therapy to adult and geriatric patients.Prepare accurate documentation, progress notes,...
-
Physical Therapy Assistant
4 weeks ago
Owensboro, Kentucky, United States Cornerstone Rehab Full timeJob SummaryWe are seeking a skilled Physical Therapy Assistant to join our team at Cornerstone Rehab. As a PRN Physical Therapy Assistant, you will deliver high-quality care to our patients and collaborate with a diverse team of clinical professionals.Key Responsibilities:Provide physical therapy services to adult and geriatric patients in skilled nursing...
-
Speech Language Pathologist
3 weeks ago
Owensboro, Kentucky, United States Cornerstone Rehab Full timeWe are seeking a skilled Speech Language Pathologist to join our team at Cornerstone Rehab, delivering high-quality care to adult and geriatric patients.As a key member of our clinical team, you will provide speech therapy services, prepare comprehensive documentation, and establish personalized plans of care.Responsibilities:Deliver speech therapy services...
-
Clinical Therapist
4 weeks ago
Owensboro, Kentucky, United States Addiction Recovery Care Full timeJob DescriptionWe are seeking a highly skilled and compassionate Clinical Therapist to join our growing clinical team at Addiction Recovery Care, LLC. As a Clinical Therapist, you will be responsible for providing direct patient services, including initial assessments, diagnosis, and documentation of each event necessary to determine placement for level of...
-
Patient Care Technician
3 weeks ago
Owensboro, Kentucky, United States DaVita Full timeAbout the Role:DaVita is seeking a skilled Patient Care Technician to join our team of healthcare professionals. As a Patient Care Technician, you will play a vital role in providing direct patient care and ensuring the comfort and well-being of our patients undergoing dialysis treatment.Key Responsibilities: Provide direct patient care, including monitoring...
-
Nurse Practitioner
3 weeks ago
Owensboro, Kentucky, United States Matrix Medical Network Full timeAbout UsMatrix Medical Network is a leading provider of clinical services and care management solutions. Our team of experienced clinicians works with primary care providers and at-risk health plan members to improve health outcomes and quality of care.We offer a range of services, including home risk assessments, skilled facility visits, and telehealth...
-
Licensed Practical Nurse
2 weeks ago
Owensboro, Kentucky, United States LHC Group Full timeJob SummaryWe are seeking a skilled Licensed Practical Nurse (LPN) to join our team in providing high-quality care to patients in their homes. As a Private Duty Nurse, you will be responsible for delivering direct nursing care as prescribed by the physician, recording clinical and progress notes, and coordinating other patient care activities to provide the...
-
Substance Abuse Counselor
1 month ago
Owensboro, United States Pinnacle Treatment Centers Full timeOverview: We offer competitive salaries, full benefits package, Paid Time Off, and opportunities for professional growth.Pinnacle Treatment Centers is a growing leader in addiction treatment services. We provide care across the nation touching the lives of more than 30,000 patients daily.Our mission is to remove all barriers to recovery and transform...
-
Physical Therapist Assistant
4 weeks ago
Owensboro, Kentucky, United States Upstream Rehabilitation Inc. Full timeBenchMark Physical Therapy, a brand partner of Upstream Rehabilitation, is seeking a Physical Therapist Assistant to provide evidence-based treatment in Owensboro West, KY.A network of over 1200 clinics from coast to coast, 26 brand partners, leads the outpatient physical therapy field.The Upstream family offers various career paths for clinicians, including...
-
LPN - Home Health Care Specialist
4 weeks ago
Owensboro, Kentucky, United States Enhabit Home Health & Hospice Full timeJoin Our Team at Enhabit Home Health & HospiceWe are seeking a dedicated and compassionate LPN to join our team as a Home Health Nurse. As a national leader in home-based care, Enhabit is committed to providing exceptional patient care and fostering a collaborative work environment.About the RoleAs a Home Health Nurse, you will visit patients in their homes...
-
Clinical Team Leader Home Health Specialist
4 weeks ago
Owensboro, Kentucky, United States Enhabit Home Health & Hospice Full timeOverviewEnhabit Home Health & Hospice is a national leader in home-based care, consistently ranked as one of the best places to work in the country. We're committed to expanding what's possible for patient care in the home, fostering a unique culture that's both innovative and collaborative.ResponsibilitiesAs a Clinical Team Leader, you'll play a key role in...
-
Licensed Practical Nurse- Home Care
1 month ago
Owensboro, United States LHC Group Full timeSummary We are now hiring an LPN for Private Duty Home Care in Whitesville, KY. * 8 hour days (7 AM-3 PM) or evenings (3 PM-11 PM) skilled visits available * One-on-one patient care * Weekly Pay * Flexible schedules * Earn PTO hours and benefits when working 32+ hours a week As a Licensed Practical/Vocational Nurse (LPN/LVN), you can expect: *...