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Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Molina Healthcare is an Equal Opportunity Employer (
Behavioral Health- Care Review Clinician (RN- Utilization Manager- NV based)Coordinates implementation of the plan of care through a multidisciplinary home care or hospice team, community resources and the physician. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. We are locall
RN - Complete Care Program - Home Health Case ManagerInvestigates complaints alleging inappropriate Physical Health (PH) clinical care or alleged inappropriate behavior by a physician or other health care practitioner/provider. With guidance, reviews, responds to, and researches complaints related to quality of medical care utilizing a high level of k
Regulatory Quality RN Clinical Care-IntermediateOur health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. If you're exploring career advancement or looking to highlight your skills online, understanding the impact and responsibilities of a Clinical Practice Sp
RN - Clinical Practice Specialist - Clovis and TucumcariCurrent national MA certification from one of the following national MA certifications or registrations: Registered Medical Assistant (RMA) of AMT, National Certified Medical Assistant (NCMA), Certified Clinical Medical Assistant (CCMA) or Certified Medical Assistant (CMA) of the AAMA. Proof of comp
Medical Assistant Primary CareRose Dominican is a member of CommonSpirit Health, one of the nation's largest healthcare systems, a 22-state network of more than 9000 physicians, 60000 employees and 400 care centers including hospitals, urgent and occupational care imaging and surgery centers, home health and primary care clinics
Critical Care Intensivist PhysicianCurrent national MA certification from one of the following national MA certifications or registrations: Registered Medical Assistant (RMA) of AMT, National Certified Medical Assistant (NCMA), Certified Clinical Medical Assistant (CCMA) or Certified Medical Assistant (CMA) of the AAMA. As a Medical
Medical Assistant Primary Senior CareAs a Medical Oncology Physician in Oncology, at Intermountain Health in Southern Nevada you will work with a dedicated tight knit team of healthcare professionals committed to providing quality care and an excellent patient experience. Intermountain Healthcare Oncology/Hematology provides patients w
Medical Oncology, PhysicianAbout CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As the largest provider of senior-focused primary care, a leading
Clinical Care Nurse (RN)