• Behavioral Health Care Review

    Molina Healthcare (Owensboro, KY)
    …Licensed Masters Level social worker with a current active license for state of KY. The Care Review Clinician Inpatient Review BH will provide prior ... more
    Molina Healthcare (04/03/25)
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  • Care Review Clinician

    Molina Healthcare (Columbus, OH)
    …Registered Nurse who has a OH Licensure and/or have Compact RN license. The Care Review Clinician will provide prior authorization for outpatient services ... more
    Molina Healthcare (03/29/25)
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  • LPN Care Review Clinician

    Molina Healthcare (Manhattan, NY)
    …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... more
    Molina Healthcare (04/02/25)
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  • LPN Care Review Clinician

    Molina Healthcare (Vancouver, WA)
    …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... more
    Molina Healthcare (03/22/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Columbus, OH)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... more
    Molina Healthcare (03/07/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Brooklyn, NY)
    …eligible for Medicaid and Medicare. We are looking for Registered Nurse Care Review Clinicians with Prior Authorization experience. Experience with Utilization ... more
    Molina Healthcare (04/02/25)
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  • Care Review Clinician

    Molina Healthcare (Columbus, OH)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... more
    Molina Healthcare (03/29/25)
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  • Care Review Clinician , IP…

    Molina Healthcare (Bothell, WA)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... more
    Molina Healthcare (04/03/25)
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  • Care Review Clinician , Prior…

    Molina Healthcare (Columbus, OH)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... more
    Molina Healthcare (03/21/25)
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  • Excess Risk Managed Care Clinician

    Highmark Health (Carson City, NV)
    …assessments regarding potential claims.Communicate with TPA Case Managers and/or their contracted CM/ UM vendors to ensure effective case/ care management, of all ... more
    Highmark Health (02/24/25)
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  • Inpatient Review Clinician (RN)…

    Molina Healthcare (San Diego, CA)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... more
    Molina Healthcare (03/29/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... more
    US Tech Solutions (01/17/25)
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  • Behavioral Health Utilization Management Reviewer

    AmeriHealth Caritas (Charleston, SC)
    …and providers to collect all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer's discretion to retain ... more
    AmeriHealth Caritas (03/18/25)
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  • Utilization Review Nurse

    US Tech Solutions (May, OK)
    …. MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... more
    US Tech Solutions (01/17/25)
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  • Manager, Programs

    University of Miami (Miami, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... more
    University of Miami (03/18/25)
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  • RN Case Manager

    Covenant Health (Nashua, NH)
    …clinical outcomes. The RN Case Manager works closely with, and delegates care to, the High-Risk Social Worker/Behavioral Health Clinician because of ... more
    Covenant Health (03/25/25)
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  • Manager, Programs

    University of Miami (Miami, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... more
    University of Miami (02/04/25)
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  • Nurse Case Manager - Full Time, DAYS

    Albany Medical Center (Albany, NY)
    Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Salary Range: $71,612.39 - $110,999.20 The Case Manager is accountable to ... more
    Albany Medical Center (03/08/25)
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  • Assistant Professor of Clinical - OBGYN, Pediatric…

    University of Miami (Miami, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... more
    University of Miami (01/24/25)
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  • Quality Management Nurse Consultant

    US Tech Solutions (RI)
    …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... more
    US Tech Solutions (01/17/25)
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