• RN UM Care Review…

    Molina Healthcare (Sioux City, IA)
    JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for ... care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/13/25)
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  • RN UM Clinical Appeals Nurse…

    Molina Healthcare (Des Moines, IA)
    …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...to overarching strategy to provide quality and cost-effective member care . Candidates with UM and Appeals experience… more
    Molina Healthcare (11/14/25)
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  • RN Care Review Clinician…

    Molina Healthcare (Sioux City, IA)
    JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for clinical member services review assessment processes. Responsible for ... care . We are seeking a candidate with a RN licensure that has previous UM and...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Iowa City, IA)
    For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Iowa City, IA)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM...unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician, PA…

    Molina Healthcare (Sioux City, IA)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional… more
    Molina Healthcare (10/26/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Cedar Rapids, IA)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and… more
    Molina Healthcare (11/21/25)
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  • RN - Utilization Review

    UnityPoint Health (Cedar Rapids, IA)
    …and health care decision-making. Qualifications + State of Iowa Licensed RN + Two years of behavioral health work experience. + Professional communication - ... + Area of Interest: Patient Care + FTE/Hours per pay period: 1.0 +...optimal clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients… more
    UnityPoint Health (11/07/25)
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  • RN - Clinical Coord

    UnityPoint Health (Cedar Rapids, IA)
    …+ Identifies needed interventions, and communicates and collaborates with physician and primary nurse to individualize plan of care to meet patient's needs. + ... Patient Care Coordinator role is designed predominantly for an RN , although candidates with commiserate healthcare experience may be considered. Baccalaureate… more
    UnityPoint Health (11/19/25)
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  • Denials Prevention Specialist, Clinician PRN

    Datavant (Des Moines, IA)
    …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...bring to the table:** + Two (2) years managed care experience in UM /CM/CDI Department preferred +… more
    Datavant (11/12/25)
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