• RN UM Care Review

    Molina Healthcare (Springfield, MA)
    JOB DESCRIPTION Job Summary The Care Review Clinician , IP Provides support for clinical member services review assessment processes. Responsible for ... a candidate with a MA RN licensure. Candidates with UM Medical Review background and experience using...* Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM more
    Molina Healthcare (10/18/25)
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  • RN - UM / Medical Management Nurse…

    Elevance Health (Las Vegas, NV)
    …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education and ... Med/Surg, Critical Care , ER, Telemetry, etc. strongly preferred. + Utilization management/ review within managed care or hospital strongly preferred. + NICU /… more
    Elevance Health (10/22/25)
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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 (10/24/25)
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  • Care Review Clinician - NM…

    Molina Healthcare (Dallas, TX)
    …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). Must be able… more
    Molina Healthcare (10/26/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (WA)
    …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
    Molina Healthcare (10/24/25)
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  • Care Review Clinician (LVN…

    Molina Healthcare (Cedar Rapids, IA)
    …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... health care experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
    Molina Healthcare (10/22/25)
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  • Care Review Clinician (RN)…

    Molina Healthcare (Los Angeles, CA)
    …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
    Molina Healthcare (10/18/25)
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  • Care Review Clinician RN (BH…

    Molina Healthcare (AZ)
    …to other clinical programs. * Collaborates with multidisciplinary teams to promote Molina care model. * Adheres to utilization management ( UM ) policies and ... At least 2 years of experience with inpatient concurrent review , prior authorization and managed care ; Acute care hospital experience with discharge planning… more
    Molina Healthcare (10/26/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Nampa, ID)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... good standing. **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 (10/26/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (AZ)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... good standing. **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 (10/26/25)
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