- Molina Healthcare (Boise, ID)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and… more
- Molina Healthcare (Boise, ID)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for ... care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Nampa, ID)
- …Minimum 3 years of experience as a Registered Nurse and/or Nurse Practitioner, ideally in managed care , behavioral health, or utilization management. + ... with physicians to ensure clinically appropriate, cost-effective, and regulatory-compliant care determinations. Assists in evaluating medical necessity, ensuring timeliness,… more
- Magellan Health Services (Boise, ID)
- …- Care MgmtCare Mgmt, PC - Professional Counselor - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... development and on-going management of designated staff. + Performs care management review activities consistent with Magellan...required: BCBA, LCSW, LMFT, LMSW, LPCC, LPC, PC or RN . If RN , BSN preferred but ASN… more
- Molina Healthcare (Nampa, ID)
- JOB DESCRIPTION Job Summary The Care Review Clinician RN provides support for clinical member services review assessment processes. Responsible for ... care . We are seeking a candidate with a RN licensure that has previous UM and...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Nampa, ID)
- 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 ... * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Nampa, ID)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional… more
- Molina Healthcare (Nampa, ID)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and… more
- Datavant (Boise, ID)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...bring to the table:** + Two (2) years managed care experience in UM /CM/CDI Department preferred +… more
- Highmark Health (Boise, ID)
- …and/or triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established ... in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced...in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
