Utilization Review Nurse: Medical Claims & Care Validation
Listed on 2026-10-15
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Nursing
Healthcare Nursing
Molina Healthcare is seeking a Nurse Reviewer to support utilization management in Arizona. You will review documentation to confirm medical necessity and appropriate care level using MCG/Inter Qual guidelines and Molina policies, validating records to ensure accurate reimbursement for providers.
Responsibilities include prospective/retrospective/concurrent reviews for denials, DRG validation, and appeals support.
For the Utilization Review Nurse:
Medical Claims & Care Validation position at Molina Healthcare, we are reviewing applications now.
Please review the full job details above before applying.
If your experience matches this role, we encourage you to apply.
All applications are reviewed carefully by our team.
The position is based in Glendale, AZ, United States.
This opportunity is part of our work in Legal, Bio & Pharmacology & Health.
The advertised compensation is 40.000 - 79.000.
We aim to respond to suitable candidates as soon as possible.
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