- Centene Corporation (Frankfort, KY)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- Molina Healthcare (KY)
- …position we are seeking a REGISTERED NURSE with previous experience in Concurrent Review /_** **_Utilization Review / Utilization Management and knowledge ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Molina Healthcare (KY)
- … Clinical Social Worker (LCSW) previous experience in Hospital Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Molina Healthcare (KY)
- …a REGISTERED NURSE with previous experience in Hospital Acute Care, Concurrent Review /_** **_Utilization Review / Utilization Management and knowledge ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Molina Healthcare (Owensboro, KY)
- …a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Molina Healthcare (KY)
- …seeking a LVN / LPN or RN Nurse with previous experience in Concurrent Review /_** **_Utilization Review / Utilization Management and knowledge of ... in a healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review ...Nurse (LPN) license in good standing OR a clinical license in good standing, such as LCSW, LPCC… more
- Molina Healthcare (Louisville, KY)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in… more