- Molina Healthcare (Syracuse, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... and cost-effective member care. The candidate must have a RN licensure and experience with medical surgical,...intensive care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work… more
- Molina Healthcare (Buffalo, NY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and member/provider… more
- MVP Health Care (Tarrytown, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Professional, Sub-Acute RN UM Reviewer - Medicare** to join #TeamMVP. If you have a ... our Talent team at ###@mvphealthcare.com . **Job Details** **Job Family** ** Medical Management /Clinical** **Pay Type** **Salary** **Hiring Min Rate** **56,200… more
- Molina Healthcare (Rochester, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... member care. We are seeking a candidate with a RN licensure that has previous UM and...promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications**… more
- Molina Healthcare (Buffalo, NY)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Rochester, NY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …(ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, Geriatrics, etc.) to ... consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and… more
- Molina Healthcare (NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2… more
- Molina Healthcare (Syracuse, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …with Provider Relations, explaining processes for accessing Health Plan to perform medical review, obtains case or disease management support, or otherwise ... coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and… more