• Care Review Clinician

    Molina Healthcare (MS)
    …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina...such as LCSW, LPCC or LMFT (for Behavioral Health Care Review Clinicians only). Must be able… more
    Molina Healthcare (09/06/25)
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  • Care Review Clinician (LVN)…

    Molina Healthcare (Fort Worth, TX)
    …At least 2 years health care experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or ... a TX licensed LVN with Utilization Management experience to join our Prior Authorization reviewing team. Previous UM experience with MCG/Interqual guidelines as well… more
    Molina Healthcare (10/30/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (WA)
    …Required Qualifications * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , ... or emergency room. Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
    Molina Healthcare (10/24/25)
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  • Care Review Clinician LVN

    Molina Healthcare (San Francisco, CA)
    …At least 2 years health care experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or ... hospital experience in a medical unit or emergency room. Previous experience in Prior Auth, Utilization Review / Utilization Management and knowledge of… more
    Molina Healthcare (11/01/25)
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  • Care Review Clinician (LVN…

    Molina Healthcare (Cedar Rapids, IA)
    …At least 2 years health care experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or ... in a medical unit or emergency room. Previous experience in ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (10/22/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Cleveland, OH)
    …Required Qualifications * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , ... on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member… more
    Molina Healthcare (11/01/25)
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  • Care Review Clinician (RN)…

    Molina Healthcare (Los Angeles, CA)
    …Qualifications** * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , ... California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_3-12 NIGHT SHIFT 7:30PM - 08:30AM PACIFIC HOURS NON EXEMPT, 3 days a week will… more
    Molina Healthcare (10/18/25)
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  • Care Review Clinician RN (BH…

    Molina Healthcare (NM)
    …experience with MCG guidelines. At least 2 years of experience with inpatient concurrent review , prior authorization and managed care ; Acute care ... .** JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services… more
    Molina Healthcare (10/26/25)
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  • Utilization Review Clinician

    Centene Corporation (Honolulu, HI)
    review process preferred. Experience working with providers and healthcare teams to review care services related to mental health and substance abuse ... Utilization Management experience strongly preferred.** **Position Purpose:** Performs a clinical review and assesses care related to mental health and… more
    Centene Corporation (10/30/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (NM)
    …Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
    Molina Healthcare (10/26/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Nampa, ID)
    …Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
    Molina Healthcare (10/26/25)
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  • Care Review Clinician

    Molina Healthcare (Reno, NV)
    **Job Description** **Job Summary** Provides support for member clinical review processes specific to applied behavioral analysis (ABA) services. Responsible for ... - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality… more
    Molina Healthcare (08/31/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Downers Grove, IL)
    …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
    Molina Healthcare (10/18/25)
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  • Pavilion Health Clinician -Educator

    University of Colorado (Aurora, CO)
    **Pavilion Health Clinician -Educator** **Description** **University of Colorado Anschutz Medical Campus** **Department: Medicine- General Internal Medicine** **Job ... Title: Pavilion Health Clinician -Educator** **Position #00819385 - Requisition #32720** **Job Summary:** Key...patients per day, ensuring ample time to provide thorough care without feeling rushed + **Efficient workflow** - Doctors… more
    University of Colorado (09/06/25)
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  • Sr. Clinician

    UPMC (Greenville, PA)
    …in the achievement of a culture of excellence in professional nursing practice and patient care . The Sr. Clinician , under the direction of the Unit Director or ... through the use of the nursing process. The Sr. Clinician , in collaboration with other health care ...review process. Four years of nursing experience required. Prior progressive leadership experience strongly preferred for external hires.… more
    UPMC (10/30/25)
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  • Behavioral Health Clinician

    Commonwealth Care Alliance (Springfield, MA)
    …or urgent visits to maintain expected productivity. + Review members' quality gaps prior to every visit and collaborate with care team to close these gaps. ... care delivery. Within the CIC Program, The Senior Clinician , Behavioral Health (SBHC) serves as a leader for...CCA quality improvement efforts + Participates in regular Interprofessional Care Team meetings and Team Case Review .… more
    Commonwealth Care Alliance (10/08/25)
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  • Utilization Review Clinician

    Centene Corporation (San Diego, CA)
    …abuse is preferred. + Experience working with providers and healthcare teams to review care services, precertification, concurrent review , discharge reviews ... or Remote - TX** **Position Purpose:** Performs a clinical review and assesses care related to mental...care and services are medically appropriate + Performs prior authorization reviews related to mental health and substance… more
    Centene Corporation (10/29/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Richmond, VA)
    … process required. Experience working with providers and healthcare teams to review care services related to Applied Behavior Analysis Services preferred. ... including a fresh perspective on workplace flexibility. M-F 8-5 EST/CST Partnerships In Care Program **Position Purpose:** Performs reviews of member's care and… more
    Centene Corporation (10/30/25)
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  • Mental Health Clinician II (Staffing…

    State of Colorado (Denver, CO)
    …basis. Preferred Qualifications: + 1+ years Knowledge and Experience as Mental Health Care Clinician I at a State of Colorado Mental Health Institute. ... Mental Health Clinician II (Staffing Department Rover)-Colorado Mental Health Hospital at Fort Logan Print… more
    State of Colorado (10/18/25)
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  • CDOC (Social Worker/Counselor III) - Mental Health…

    State of Colorado (Chaffee County, CO)
    …housing, and does not operate the housing. Description of Job Mental Health Clinician : This position provides mental health care to a special population ... CDOC (Social Worker/Counselor III) - Mental Health Clinician - (BUENA VISTA) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5100324) Apply … more
    State of Colorado (10/16/25)
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