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Kentucky Licensed Care Review ClinicianVirtualVocations • Tulsa, Oklahoma, United States
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Kentucky Licensed Care Review Clinician

Kentucky Licensed Care Review Clinician

VirtualVocations • Tulsa, Oklahoma, United States
5 days ago
Job type
  • Full-time
Job description
To support clinical member services, the full-time Kentucky Licensed Care Review Clinician will assess the medical necessity of services, analyze clinical requests, and ensure compliance with established guidelines while working remotely. Key responsibilities Assess services for members to ensure optimal outcomes and compliance with regulations Analyze clinical service requests against evidence-based guidelines and determine prior authorization needs Collaborate with multidisciplinary teams to promote the integrated Molina care model Required qualifications At least 2 years of experience in hospital acute care, inpatient review, or managed care Active and unrestricted Registered Nurse (RN) license in the state of practice Proficiency in Microsoft Office and applicable software programs Strong organizational and critical-thinking skills Ability to manage multiple deadlines effectively
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Kentucky Licensed Care Review Clinician • Tulsa, Oklahoma, United States

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