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Molina HealthcareNew
Overview
Responsible for verifying that clinical services are medically necessary and align with established guidelines and insurance policies. Collaborates with multidisciplinary teams to ensure cost-effective member care and compliance with state and federal regulations.
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Compensation
$24 - $56 / HOUR
Posted
New
Molina Healthcare
Responsible for verifying that clinical services are medically necessary and align with established guidelines and insurance policies. The role involves analyzing service requests, processing prior authorizations, and collaborating with multidisciplinary teams to ensure cost-effective member care.
$24 - $51 / HOUR
13 days ago
Conducts clinical service reviews for behavioral health members to ensure medical necessity and compliance with guidelines. Collaborates with multidisciplinary teams to manage care outcomes and process prior authorizations within required timelines.
$26 - $51 / HOUR
20 days ago
The clinician is responsible for assessing service requests to ensure medical necessity, cost-effectiveness, and compliance with clinical guidelines and regulations. They collaborate with multidisciplinary teams and medical directors to facilitate appropriate care outcomes for members.
Salary not listed
1 month ago
The clinician is responsible for conducting clinical service reviews to ensure medical necessity and compliance with behavioral health guidelines. They collaborate with multidisciplinary teams and providers to manage member care and facilitate appropriate treatment authorizations.
The clinician assesses service requests for medical necessity and compliance with clinical guidelines to ensure cost-effective member care. They collaborate with multidisciplinary teams and medical directors to manage prior authorizations and support the integrated delivery of care.
