Care Review Clinician - UR RN

Job Description:

Are you an experienced Registered Nurse looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Daily Responsibilities:

• Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team

- Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.

- Providing utilization review for the Medicaid and Medicare line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare

Hours for this Position:

• Mon-Fri 8:30am-5pm

Advantages of this Opportunity:

• Competitive salary, negotiable based on relevant experience

• Acquire new skills and broaden your experience / expertise

• Fun and positive work environment

Qualifications/ Requirements:

• Utilization Review background in either Managed Care of Provider environment (at least one year)

• RN License in Michigan

• Interqual experience (at least one year)

• Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management