• Care Review Clinician

    Molina Healthcare (Fort Worth, TX)
    …intensive care unit or emergency room. + Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and ... zone residents preferred** **Job Description** **Job Summary** Supports the clinical review process of provider requests to ensure that behavioral health services… more
    Molina Healthcare (07/18/25)
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  • Care Review Clinician

    Molina Healthcare (San Jose, CA)
    …Bachelor's Degree in Nursing **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization ... California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_3-12 DAY SHIFT 7:30AM - 08:30PM...assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long… more
    Molina Healthcare (05/07/25)
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  • Care Review Clinician

    Molina Healthcare (Austin, TX)
    …Bachelor's Degree in Nursing **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care ,… more
    Molina Healthcare (07/18/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Omaha, NE)
    …with some weekends and holidays.** Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
    Molina Healthcare (07/17/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Buffalo, NY)
    …(RN) license in good standing. **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
    Molina Healthcare (07/17/25)
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  • Care Review Clinician

    Molina Healthcare (Everett, WA)
    …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
    Molina Healthcare (07/17/25)
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  • Care Review Clinician

    Molina Healthcare (Syracuse, NY)
    …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care , ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
    Molina Healthcare (06/29/25)
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  • BH Utilization Review Clinician

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician , Behavioral Health Utilization Review will review behavioral health and substance ... and assist with transition of care planning and coordination when a Commonwealth Care Alliance clinician is not already involved. Work with ESPs to ensure… more
    Commonwealth Care Alliance (05/21/25)
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  • Utilization Review Clinician

    Monte Nido (Miami, FL)
    …comprehensive care within an intimate home setting. The Utilization Review ** Clinician ** is responsible for conducting daily administrative and professional ... opportunity for people to realize their healthy selves. **Utilization Review Clinician ** **Monte Nido** **Remote - Pacific...active treatment team member providing payor needs for next review , guidance on level of care recommendations,… more
    Monte Nido (07/18/25)
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  • Utilization Review Clinician (Santa…

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $31.50-37.50 Per Hour ... and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further training… more
    Sacramento Behavioral Healthcare Hospital (07/04/25)
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