• Utilization Review Clinician

    Centene Corporation (Atlanta, GA)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
    Centene Corporation (05/18/25)
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  • Care Review Clinician , Inpatient…

    Molina Healthcare (Atlanta, GA)
    …reliable transportation. **Preferred Experience** Previous experience in ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS… more
    Molina Healthcare (05/09/25)
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  • Care Review Clinician , PA (RN)…

    Molina Healthcare (Atlanta, GA)
    **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... transplants; the ideal candidate will have experience either in utilization review or case management for transplants....an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high… more
    Molina Healthcare (03/07/25)
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