- Molina Healthcare (St. Petersburg, FL)
- …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 (St. Petersburg, FL)
- …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 (St. Petersburg, FL)
- …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
- Zelis (St. Petersburg, FL)
- …Clinical Chart Review is focused on supervising a team of Clinician 's performing clinical reviews of facility claims, including UB's, Itemized Bills and medical ... and proven leadership experience is a must as recommendations to the Nurse Reviewer's regarding their claim management is required. Additionally, this role is… more