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M4468s6fy7k5b81jhb0

Care Review Clinician

The Judge Group Long Beach Contractor
$61,359.00 (Careerbuilder est.)
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The Judge Group is looking for a skilled Care Review Clinician!!

Job Details:

•MUST have experience reviewing Prior Authorization requests 
•Case Management experience does not qualify candidate for the position 
•InterQual or Milliman experience is desired 
•Business expectation is to review 60-65 Prior Authorization cases per day. 
•Weekend and Holiday hours may be required

Required licensure (if applicable):
Active, unrestricted State Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) in good standing

Day to Day Responsibilities:
Will be responsible for prior authorizations, for outpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time.

Provides daily review and evaluation of members that require procedures requiring prior authorizations.

Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.

If interested, please send updated resume to Mason Voge at Email blocked - click to apply !!
 

Recommended skills

Utilization Management
Licensed Vocational Nurses
Management
Prior Authorization
Licensed Practical Nurse
Medical Necessity

Location

CareerBuilder Estimated Salary What is the Careerbuilder Estimated Salary? Only about 20% of the jobs in our search results contain salary information. When a job posting doesn’t include a salary, we estimate it by looking at similar jobs in the same industry in that location. It is not necessarily endorsed by the employer and actual compensation may vary based on your experience.

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What is the Careerbuilder Estimated Salary?

Only about 20% of the jobs in our search results contain salary information. When a job posting doesn’t include a salary, we estimate it by looking at similar jobs in the same industry in that location. It is not necessarily endorsed by the employer and actual compensation may vary based on your experience.
This estimation is based on Job title, Industry, Location and Skills
$61,359
Avg. Yearly Salary
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Job ID: 635864

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