- Molina Healthcare (Los Angeles, CA)
- …Auditing, and Compliance /Quality will be a good fit for this position. Strong UM Prior Authorization experience highly preferred. Further details to be ... The **Delegation Oversight Nurse** is responsible for ensuring that Molina Healthcare's UM delegates are compliant with all applicable State, CMS, and NCQA… more
- Molina Healthcare (Los Angeles, CA)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management… more
- Molina Healthcare (Los Angeles, CA)
- …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes ... teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management… more
- Molina Healthcare (Los Angeles, CA)
- …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes ... teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management… more