• Medical Claim Review

    Molina Healthcare (Chandler, AZ)
    …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... more
    Molina Healthcare (01/25/25)
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  • Clinical Appeals Nurse (RN): Texas and New…

    Molina Healthcare (Chandler, AZ)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... more
    Molina Healthcare (02/09/25)
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  • Medical Director (Medicare)

    Molina Healthcare (Chandler, AZ)
    …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more
    Molina Healthcare (02/09/25)
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  • Medical Director Specialty Medical

    Molina Healthcare (Chandler, AZ)
    …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more
    Molina Healthcare (02/07/25)
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  • Physician Assistant - Primary Care Float

    Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
    …clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records. The full performance level of ... more
    Veterans Affairs, Veterans Health Administration (02/12/25)
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  • Case Manager RN - Remote

    CVS Health (Phoenix, AZ)
    …with some flexibility required to accommodate member's needs. Position Summary Nurse Case Manager is responsible for telephonically assessing, planning, implementing ... more
    CVS Health (02/08/25)
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  • Special Investigation Unit Manager Clinical…

    CVS Health (Phoenix, AZ)
    …Direct and oversee complex reviews. Ensure timely and accurate reporting of review findings and coordinate with investigative to take appropriate action. Conducts ... more
    CVS Health (12/25/24)
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