• 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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  • 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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  • 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 - EST...active treatment team member providing payor needs for next review , guidance on level of care recommendations,… more
    Monte Nido (06/21/25)
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  • Care Review Clinician

    Molina Healthcare (Everett, WA)
    …a candidate with a LICSW, LMFT, LMHC or LPCC licensure with previous UM and managed care experience. Proficient technology experience is highly preferred. ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other Molina… more
    Molina Healthcare (07/17/25)
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  • Care Review Clinician

    Molina Healthcare (Fort Worth, TX)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina care model. + Adheres to utilization management ( UM ) policies and ... or emergency room. + 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 (07/18/25)
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  • Care Review Clinician

    Molina Healthcare (San Jose, 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 (05/07/25)
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  • Care Review Clinician

    Molina Healthcare (Austin, TX)
    …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 (07/18/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Omaha, NE)
    …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 (07/17/25)
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  • Care Review Clinician

    Molina Healthcare (Syracuse, NY)
    …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 (06/29/25)
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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 (06/27/25)
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