- Molina Healthcare (NM)
- …least 2 years health care experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent ... medical unit or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization...Utilization Management and knowledge of Interqual / MCG guidelines. LVN / LPN MULTI STATE / COMPACT LICENSURE required… more
- Molina Healthcare (NM)
- …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... of an accredited Registered Nurse (RN), Licensed Vocational Nurse ( LVN ) or Licensed Practical Nurse (LPN) Program OR a...such as LCSW, LPCC or LMFT (for Behavioral Health Care Review Clinicians only). Must be able… more
- Datavant (Santa Fe, NM)
- …sciences companies, government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a high-performing, values-driven ... is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of...and necessity of continued stay in the inpatient patient care setting and/or discharge to an alternative level of… more