• Care Review Clinician

    Molina Healthcare (Madison, WI)
    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 ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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  • Care Review Clinician

    Molina Healthcare (Madison, WI)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
    Molina Healthcare (01/09/26)
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  • Care Review Clinician

    Molina Healthcare (Madison, WI)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... **_Wisconsin RN license required_** JOB DESCRIPTION Job SummaryProvides support...JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are… more
    Molina Healthcare (11/14/25)
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  • Payment Integrity Clinician

    Highmark Health (Madison, WI)
    …of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes… more
    Highmark Health (11/14/25)
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  • Clinical Supervisor - RN Hybrid

    Aveanna Healthcare (Madison, WI)
    …remain at the forefront of everything we do and receive the best care possible! Clinical Supervisor ( RN ) (Nursing Supervisor) Aveanna Healthcareis a leading ... patient intake and discharge to home, our start of care process and nurse competency validation. The...the Nursing Supervisor: + Must have good standing license ( RN ) in the state in which the clinician more
    Aveanna Healthcare (01/08/26)
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  • Specialty Clinics Assistant Nurse Manager

    Veterans Affairs, Veterans Health Administration (Madison, WI)
    …coverage for operations of the Specialty Care Clinics. The Specialty Clinics Assistant Nurse Manager is a Registered Nurse who is accountable for the ... the continuum of care . Responsibilities The Assistant Nurse Manager (ANM) is a Registered ...to day basis. The ANM participates in the development, review and revision of the Nursing policies and procedures… more
    Veterans Affairs, Veterans Health Administration (01/04/26)
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