Care Review Clinician LPN / LVN

Molina
Las Cruces, NY
Job Description
This Care Review Clinician position provides clinical support for member services review and assessment. The role involves verifying service appropriateness, identifying benefits, and coordinating with medical professionals. It contributes to a quality and cost-effective member care delivery strategy within the Molina family.

Requirements

  • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
  • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
  • Processes requests within required timelines.

Benefits

  • Competitive benefits
  • Compensation package
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