• Care Review Clinician

    Molina Healthcare (Bowling Green, KY)
    …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 (10/24/25)
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  • Care Review Clinician

    Molina Healthcare (Bowling Green, KY)
    …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 (10/17/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Bowling Green, KY)
    …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 (10/18/25)
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  • Registered Nurse ( RN )…

    HealthTrust Workforce Solutions (Nashville, TN)
    …Our partnering facility is seeking a qualified Registered Nurse ( RN )- Vascular Access- Full Time clinician . HealthTrust Offers: + Customizable Pay ... **Entrust Your Career to HealthTrust!** ** Registered Nurse ( RN ) -...responsible for the anticipation, planning, coordination, and provision of care for the patient while performing and monitoring the… more
    HealthTrust Workforce Solutions (10/11/25)
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  • RN - UM / Medical Management Nurse

    Elevance Health (Nashville, TN)
    RN - Utilization / Medical Management Nurse...and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any ... 6pm PST. Rotating Weekends and holidays. The **Medical Management Nurse ** is responsible for review of the...Care , ER, Telemetry, etc. strongly preferred. + Utilization management/ review within managed care or hospital strongly… more
    Elevance Health (10/22/25)
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  • Appeals Nurse

    Humana (Nashville, TN)
    …a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments ... and independent determination of the appropriate courses of action. The Appeals Nurse 2 reviews documentation and interprets data obtained from clinical records to… more
    Humana (10/23/25)
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