- Molina Healthcare (Roswell, NM)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... nursing experience, including at least 1 year of utilization review , medical claims review , long-term...or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must… more
- Ansible Government Solutions (Albuquerque, NM)
- Overview Ansible Government Solutions, LLC (Ansible) is seeking a Registered Nurse ( RN ) with required experience in Occupational and/or Travel Health ... 1515 Eubank Blvd SE, Albuquerque, NM 87123. The selected RN shall execute prompt, efficient, and confidential patient care...education classes offered internally + Assist with immunizations and medical review off Sandia employees who will… more
- Health Advocates Network (Albuquerque, NM)
- …Candidate must live 70+ miles from facility to qualify for this opening** The Registered Nurse ( RN ) plans and provides comprehensive nursing care including, ... medical records. *Assist Health Service Administrator with the review of medical files to determine all provided services are documented. *Closely monitor… more
- Health Advocates Network (Estancia, NM)
- **Must live 70+ miles from the facility for this opening** Job Summary: The Registered Nurse ( RN ) plans and provides comprehensive nursing care including, ... medical records. -Assist Health Service Administrator with the review of medical files to determine all provided services are documented. -Closely monitor… more
- Fresenius Medical Center (Albuquerque, NM)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Fresenius Medical Center (Farmington, NM)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… more
- Molina Healthcare (NM)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Las Cruces, NM)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Roswell, NM)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Evolent (Santa Fe, NM)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... are performed within the ** RN /LVN/LPN** scope of practice, under the Medical ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate,… more