RN Utilization Review Nurse — Appeals & Medical Necessity
Molina Healthcare of Illinois
Molina Healthcare in New York, NY is seeking a registered nurse for Utilization Management to review documentation for medical necessity and appropriate level of care using InterQual/MCG criteria and Molina policies. The role involves prospective, retrospective and concurrent reviews of prior authorizations, medical claims, and LTSS; you will coordinate with medical directors and participate in payer dispute processes, with day shift hours aligned to EST and coverage for weekends/holidays as #J-18808-Ljbffr Molina Healthcare
Vacancy posted 2 days ago
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