(RN)Care Review Clinician - Utilization Review (KY based- REMOTE)
Molina Healthcare
Strathmoor Manor, Jefferson County$44,984 - $44,984 est.Full-timeRemotePosted 11h ago
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. 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. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Assesses services for members to ensur…
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