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Field Family Nurse Practitioner (WA)
Molina Healthcare

Olympia, Washington

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Field Family Nurse Practitioner
Molina Healthcare

Yakima, Washington

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Field Family Nurse Practitioner (Boise, ID)
Molina Healthcare

Boise, Idaho

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Care Review Clinician, Inpatient Review (RN)
Molina Healthcare

Troy, Michigan

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Case Manager, LTSS
Molina Healthcare

Iowa

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Case Manager, LTSS
Molina Healthcare

Iowa

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Part Time Field Family Nurse Practitioner
Molina Healthcare

Olympia, Washington

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Sr Specialist, Quality Management Nurse (Must Reside in AZ)
Molina Healthcare

Arizona

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Transition Care Case Manager (RN): Southern California
Molina Healthcare

San Diego, California

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Sr Specialist, Quality Management Nurse (Must Reside in AZ)
Molina Healthcare

Arizona

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Field Family Nurse Practitioner (Spokane, WA)
Molina Healthcare

Spokane, Washington

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Field Case Manager, LTSS (non-RN)
Molina Healthcare

La Moille, Illinois

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Case Manager, LTSS - Field travel in Dane County, WI
Molina Healthcare

Madison, Wisconsin

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Case Manager, LTSS LCSW or LMSW Remote in New York
Molina Healthcare

United States - Nationwide

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Case Manager, LTSS (RN) - Field travel in Rock County, WI
Molina Healthcare

Janesville, Wisconsin

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Case Manager, LTSS - Field travel in Fond du Lac County, WI
Molina Healthcare

Fond du Lac, Wisconsin

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Inpatient Review Clinician (RN); California 10AM to 7PM
Molina Healthcare

California

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Case Manager, LTSS (RN) Remote in New York
Molina Healthcare

United States - Nationwide

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Case Manager (RN): Los Angeles County California
Molina Healthcare

Los Angeles, California

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Case Manager : Los Angeles County California
Molina Healthcare

Los Angeles, California

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Case Manager : Bernalillo County NM, Bilingual Spanish
Molina Healthcare

Rio Rancho, New Mexico

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Case Manager, LTSS - Field travel in Waukesha County, WI
Molina Healthcare

Waukesha, Wisconsin

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RN (Registered Nurse) Auditor, Clinical Services NEVADA
Molina Healthcare

Las Vegas, Nevada

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Clinical Appeals Nurse (RN)
Molina Healthcare

Long Beach, California

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Registered Nurse Case Manager, LTSS Remote with Field Travel in Boise Idaho
Molina Healthcare

Boise, Idaho

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Care Manager Clinical Denials
JOB SUMMARY: The Care Manager Clinical Denials (CM-CD) is responsible for the management of clinical audits and denials related to inpatient medical necessity and/or level of care, and coding. The CM-CD reviews patient medical records and all other pertinent patient information, and applies clinical and regulatory knowledge, screening criteria and judgment, as well as knowledge of payor requirements and denial reason codes/rationale, to determine why cases are denied and whether an appeal is required. For all inappropriate denials, relevant information is submitted, according to each payor's appeal timeframes, through denial management tracking software with bi-directional interface with physician advisor appeal coordinat


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