• Care Review Clinician, Prior Authorization

    Molina Healthcare (Buffalo, NY)
    …and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare ... members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information… more
    Molina Healthcare (08/31/25)
    - Related Jobs
  • Clinical Review Nurse - Prior Authorization

    Centene Corporation (New York, NY)
    …**8:30am-5pm, Monday-Friday Eastern Standard hours.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and ... teams, to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness of… more
    Centene Corporation (08/28/25)
    - Related Jobs
  • LPN Care Review Clinician, Prior

    Molina Healthcare (Everett, WA)
    …and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare ... members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information… more
    Molina Healthcare (08/24/25)
    - Related Jobs