• Care Review Clinician

    Molina Healthcare (Des Moines, IA)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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  • Care Review Clinician

    Molina Healthcare (Des Moines, IA)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... or emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization...experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (12/13/25)
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  • Payment Integrity Clinician

    Highmark Health (Des Moines, IA)
    …of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes… more
    Highmark Health (11/14/25)
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