• Case Manager Registered Nurse (Field…

    CVS Health (Chicago, IL)
    …we do it all with heart, each and every day. **Position Summary** The RN Case Manager is responsible for coordinating all case management activities with members to ... activities with members to ensure that their medical and behavioral health needs are met and to enhance the...+ Through the use of clinical tools and information/data review , conducts comprehensive assessments of member's needs and recommends… more
    CVS Health (03/15/25)
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  • Trainer - Clinical Services - Utilization

    Molina Healthcare (Kenosha, WI)
    …knowledge on the job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or Bachelor's ... SKILLS & ABILITIES** : + 2 or more years in case, disease or utilization management; managed care; or medical/ behavioral health settings. + One year of… more
    Molina Healthcare (03/13/25)
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  • Care Review Clinician, PA ( RN )…

    Molina Healthcare (Kenosha, WI)
    **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
    Molina Healthcare (03/07/25)
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  • Care Review Clinician, Inpatient…

    Molina Healthcare (Chicago, IL)
    REGISTERED NURSE must be licensed for the state of Illinois and must be willing to work CENTRAL daytime business hours 9AM to 6PM.** **JOB DESCRIPTION** **Job ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
    Molina Healthcare (02/05/25)
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  • Care Review Clinician, Inpatient…

    Molina Healthcare (Kenosha, WI)
    …acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must ... MCO (Managed Care) **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). Active, unrestricted Compact RN more
    Molina Healthcare (03/13/25)
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  • Manager, Healthcare Services (Remote)

    Molina Healthcare (Kenosha, WI)
    …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity,... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of … more
    Molina Healthcare (03/07/25)
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  • Sr Clinical Performance Consultant

    Molina Healthcare (Kenosha, WI)
    …need (up to 25%) **Job Qualifications** * Active and unrestricted Registered Nurse ( RN ) license or independent behavioral health license (LCSW, LPC, ... **Job Description** Looking for a Registrared Nurse or Licensed Social worker to support HealthPlans within Molina Healthcare. In this position you will be assisting… more
    Molina Healthcare (03/15/25)
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