Care Review Clinician, Prior Authorization

For this position we are seeking a (RN) REGISTERED NURSE with previous experience in Prior Authorizations, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.MULTI STATE / COMPACT LICENSURE IS PREFERRED FOR THIS ROLE: Excellent computer multi-tasking skills and analytical thought process is important to be successful in...

**DEPARTMENT FUNCTION**: PRIOR AUTH, ADVANCED IMAGING **WORK HOURS**: 5 days / daytime work schedule TUESDAY THRU SATURDAY **OR** SUNDAY THRU THURSDAY Further Details to be discussed during our interview process. Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and...

For this position we are seeking a (RN) REGISTERED NURSE with previous experience in Prior Authorizations, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. MULTI STATE / COMPACT LICENSURE IS PREFERRED FOR THIS ROLE: Excellent computer multi-tasking skills and analytical thought process is important to be successful in...

**JOB DESCRIPTION** For this position we are seeking a (RN) Registered Nurse who must be licensed in the state they reside. The RN will provide prior authorization for outpatient services for the UT Medicaid population. Strong outpatient medical and hospital analytical experience is needed. Excellent computer multi-tasking skills and good productivity is...

**JOB TITLE**: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSE For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. CALIFORNIA LICENSURE IS REQUIRED FOR THIS ROLE IMMEDIATELY UPON HIRE. CALIFORNIA...

Care Review Clinician, Inpatient Review - Behavioral Health For this position we are seeking a LPC or LCSW who lives in and must be licensed for the state they reside. Strong inpatient medical and analytical experience is needed. Excellent computer multi-tasking skills and good productivity is essential for this fast-paced role. Good analytical thought...

**JOB TITLE**: CARE REVIEW CLINICIAN INPATIENT REVIEW : LICENSED VOCATIONAL NURSE, CALIFORNIA LICENSED For this position we are seeking a (LVN) Licensed Vocational Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. CALIFORNIA LICENSURE IS REQUIRED FOR THIS...

Job DescriptionJOB DESCRIPTIONCare Review Clinician, Inpatient Review- Behavioral HealthFor this position we are seeking a LPC or LCSW who lives in and must be licensed for the state they reside. Strong inpatient medical and analytical experience is needed. Excellent computer multi-tasking skills and good productivity is essential for this fast-paced role....

**JOB DESCRIPTION** Care Review Clinician, Inpatient Review- Behavioral Health For this position we are seeking a LPC or LCSW who lives in and must be licensed for the state they reside. Strong inpatient medical and analytical experience is needed. Excellent computer multi-tasking skills and good productivity is essential for this fast-paced role. Good...

**JOB TITLE**: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSE For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. CALIFORNIA LICENSURE IS REQUIRED FOR THIS ROLE IMMEDIATELY UPON HIRE. CALIFORNIA...

For this position it will be helpful to have previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and prior knowledge of Interqual / MCG guidelines. Basic knowledge of Utilization Management processes desired. COMPACT LICENSURE IS REQUIRED to support multiple states. Further Details to be discussed during our...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior...

For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines. COMPACT RN LICENSURE IS REQUIRED to support multiple states. **WORK HOURS**: MONDAY THRU FRIDAY with some weekends and holidays, 830AM to 530PM business...

For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/ Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN CALIFORNIA LICENSURE IS REQUIRED FOR THIS POSITION. California is not a compact state at this time. This department operates 365 days a year and we...

For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/ Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN CALIFORNIA LICENSURE IS REQUIRED FOR THIS POSITION. California is not a compact state at this time. This department operates 365 days a year and we...

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...

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...

**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...

For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. COMPACT RN LICENSURE IS PREFERABLE to support multiple states. **WORK HOURS**: : 5 days / daytime work schedule 8:30AM to 5:30PM This department operates...

**DAY SHIFT 3-12 WORK SCHEDULE**: TRAINING SCHEDULE WILL BE Monday thru Friday 8:30AM to 5:30PM PACIFIC throughout a 2 - 3 month training and then will move to a 3 day/12 hour shift from then on. Previous experience with Utilization Management / Utilization Review is very essential to this role. Experience with Case Management is a plus. This is a remote...