• LPN Care Review Clinician

    Molina Healthcare (Everett, WA)
    …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... state LPN licensure. Candidates with case management, Utilization Management ( UM ), and direct managed care experience are...such as LCSW, LPCC or LMFT (for Behavioral Health Care Review Clinicians only). Must be able… more
    Molina Healthcare (08/24/25)
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  • Care Review Clinician , Prior…

    Molina Healthcare (Idaho Falls, ID)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... (RN) license in good standing. **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization… more
    Molina Healthcare (07/12/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Cleveland, OH)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... or a compact licensure. The ideal candidate will have experience with UM and prior authorization, within both Physical Health and Behavioral Health. Candidates… more
    Molina Healthcare (08/16/25)
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  • Care Review Clinician

    Molina Healthcare (Los Angeles, CA)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... in Nursing **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of InterQual /… more
    Molina Healthcare (09/06/25)
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  • Care Review Clinician , Prior…

    Molina Healthcare (Buffalo, NY)
    …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies...such as LCSW, LPCC or LMFT (for Behavioral Health Care Review Clinicians only). **MULTI STATE /… more
    Molina Healthcare (08/31/25)
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  • Care Review Clinician

    Molina Healthcare (Sacramento, CA)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... compact state. **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (08/24/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Miami, FL)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... and holidays.** Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (08/23/25)
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  • Care Review Clinician

    Molina Healthcare (Cedar Rapids, IA)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... 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 (08/31/25)
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  • Utilization Review Clinician

    Centene Corporation (Springfield, IL)
    review process preferred. Experience working with providers and healthcare teams to review care services related to mental health and substance abuse ... experience in mental health settings and utilization management / review . * Department: PHCO BH UM supporting...rotation, and occasional overtime **Position Purpose:** Performs a clinical review and assesses care related to mental… more
    Centene Corporation (08/21/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …with the VP of UM to direct the efforts of the utilization review and pre-certification functions to accomplish objectives within policy and budget. + Serve as a ... the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director will...on a weekly basis + Provide education to internal care management and clinician staff + Provide… more
    Commonwealth Care Alliance (09/05/25)
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