- Molina Healthcare (Reno, NV)
- …Business Hours .** JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying ... that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations, and ensuring members reach desired… more
- Elevance Health (Las Vegas, NV)
- …you will make an impact:** + Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary ... quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as appropriate.… more