Care Review RN: Utilization & Prior Authorization

Molina Healthcare, Inc. in New Mexico is seeking a Registered Nurse to support clinical member services review and assessment processes. The role focuses on verifying medical necessity and alignment with guidelines and policies to ensure quality, cost-effective member care.

The ideal candidate will bring experience in UM reviews and knowledge of NM Medicaid policies, collaborating with multidisciplinary teams to promote Molina’s care model.

Consider building your career as a Care Review RN:
Utilization & Prior Authorization at Molina Healthcare, Inc.

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 Los Lunas, NM, United States.

This opportunity is part of our work in Bio & Pharmacology & Health.