• Care Review Clinician (RN)

    Molina Healthcare (Grand Rapids, MI)
    …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
    Molina Healthcare (11/21/25)
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  • Patient Coordinator- Per Diem

    Akumin (Baraga, MI)
    …responsibility. + May be responsible for verifying insurance coverage and obtain prior authorization . Patient Assistance: + May perform preliminary screening of ... patients prior to procedures, which may include medical history. +...May schedule patient appointments and obtain insurance verification and/or authorization . + May prepare medical records for physicians, patients… more
    Akumin (11/14/25)
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  • Care Review Clinician (LVN/ LPN)

    Molina Healthcare (MI)
    …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... health care experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
    Molina Healthcare (11/12/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (Sterling Heights, MI)
    …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional… more
    Molina Healthcare (11/06/25)
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  • Medical Director Associate - CarelonRx

    Elevance Health (Dearborn, MI)
    …and improve member outcomes. The **Medical Director Associate- CarelonRx** supports pharmacy prior authorization reviews to ensure turnaround time is met and ... timely and consistent responses to members and providers. + Conducts peer-to-peer prior authorization reviews for medications with attending physicians or other… more
    Elevance Health (11/05/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Grand Rapids, MI)
    …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
    Molina Healthcare (11/23/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (MI)
    …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
    Molina Healthcare (11/21/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Warren, MI)
    …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
    Molina Healthcare (11/21/25)
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  • Representative, Pharmacy

    Molina Healthcare (MI)
    …Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims ... not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and providers with… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Sterling Heights, MI)
    …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
    Molina Healthcare (11/21/25)
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