• Care Review Clinician, PA (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 (12/20/24)
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  • Appeals Manager, Department of Utilization Case…

    BronxCare Health System (Bronx, NY)
    …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... and develop strong appeals for the purpose of securing reimbursement for acute care services provided to patients. Assist in development of strategies for denial… more
    BronxCare Health System (12/18/24)
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