- Molina Healthcare (Albuquerque, NM)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... emergency room. 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 (Rio Rancho, NM)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- Molina Healthcare (NM)
- …experience with MCG guidelines. At least 2 years of experience with inpatient concurrent review , prior authorization and managed care ; Acute care hospital ... .** JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services… more
- Molina Healthcare (NM)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Santa Fe, NM)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Roswell, NM)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- CVS Health (Santa Fe, NM)
- …residence. + 3+ years clinical experience. **Preferred Qualifications** + Appeals, Managed Care , or Utilization Review experience. + Proficiency with computer ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...**Position Summary** CVS Aetna is seeking a dedicated **Appeals Nurse Consultant** to join our remote team. In this… more