- Molina Healthcare (Roswell, NM)
- **JOB DESCRIPTION** For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside This position will support Medical Review ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
- Molina Healthcare (NM)
- …decision making pertinent to clinical experience + Documents clinical review summaries, bill audit findings and audit details in the database + Provides ... of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Horizon Services, Inc. (Albuquerque, NM)
- …after 6 months, and $500 after 12 months of employment) JOB TITLE: Program Nurse Manager LOCATION: Gateway Medical Sobering Center, New Mexico Who are we? Horizon ... This position, which must be held by a Registered Nurse (RN), serves as the clinical and operational lead...of Staff and Clients + Oversees proper deployment and utilization of patient monitoring technology + Provide periodic inspection… more
- Magellan Health Services (Albuquerque, NM)
- …and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care management staff, providing expertise in ... and other metrics. + Supervises care management staff through approved audit processes including performing annual reviews and provides counseling and disciplinary… more
- Genesis Healthcare (Santa Fe, NM)
- …among residents of skilled nursing and senior living facilities. Our physicians, nurse practitioners (NPs) and physician assistants (PAs) are supported by a clinical ... assigned Centers and AlignMed Partners managers to oversee the implementation, utilization , and outcomes measurement of AlignMed Partners Clinical Programs and… more
- YesCare Corp (Las Cruces, NM)
- …schedule. Weekdays or weekends **Administrative** + Serve as Chairman of the Medical Audit Committee. + Consult with medical providers in the community to resolve ... of care and chart reviews as requested. Sponsors physician assistants or nurse practitioners as required. + Notifies Regional Medical Director and Site Health… more