• Care Review Clinician, PA (RN) Remote…

    Molina Healthcare (Yonkers, NY)
    …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... illness and the site of service. We are seeking a candidate with a RN licensure, UM and Inpatient Review experience. The Care Review Clinician must be able to… more
    Molina Healthcare (03/21/25)
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  • Care Review Clinician, PA (RN) - Transplant…

    Molina Healthcare (Yonkers, NY)
    …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... 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, Prior Auth (RN)

    Molina Healthcare (Yonkers, NY)
    …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... 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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  • Trainer - Clinical Services - Utilization Review…

    Molina Healthcare (Yonkers, NY)
    …on the job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse (RN) Program and an Associate's or Bachelor's Degree in ... topics using clinical expertise gained through previous experience in either UM or CM. Applies critical thinking skills, clinical/professional judgement, and breaks… more
    Molina Healthcare (03/13/25)
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  • Program Manager, HCS RN, LMSW, LMHC, LMFT, or LPC…

    Molina Healthcare (Yonkers, NY)
    …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... RN, LMSW, LMHC, LMFT, or LPC licensure with previous UM , Case Management, and managed care experience....Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.… more
    Molina Healthcare (03/21/25)
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  • Clinical Evaluation Manager

    VNS Health (Manhattan, NY)
    …assigned. Qualifications Licenses and Certifications: + Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York ... Certified Case Manager preferred + For SelectHealth ETE Only: Nurse Practitioner (NP) certification with background or degree in...UM Only: Experience must be with a Managed Care Organization or Health Plan. CAREERS AT VNS Health… more
    VNS Health (03/11/25)
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  • Clinical Evaluation Manager

    VNS Health (Manhattan, NY)
    …as assigned. QualificationsLicenses and Certifications: Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York ... required Certified Case Manager preferred For SelectHealth ETE Only: Nurse Practitioner (NP) certification with background or degree in...UM Only: Experience must be with a Managed Care Organization or Health Plan. For SelectHealth ETE Only:… more
    VNS Health (03/11/25)
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  • Inpatient Review (RN): Remote, California ( 3-12…

    Molina Healthcare (Yonkers, NY)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_2 openings for 12 hour NIGHT SHIFT:...assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long… more
    Molina Healthcare (02/14/25)
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