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Healthcare Compliance Healthcare Administration

RN Medical Review & Utilization Auditor

Job in Omaha, Douglas County, Nebraska, 68197, USA
Listing for: Molina Healthcare
Full Time position
Listed on 2026-01-12
Job specializations:
  • Healthcare
    Healthcare Compliance, Healthcare Administration
Job Description & How to Apply Below
A healthcare provider is seeking a Clinical Review Nurse in Omaha, NE to support medical claim reviews. The role involves validating medical records, ensuring compliance with regulations, and resolving escalated complaints. Candidates should hold an active RN license with at least two years of clinical experience, particularly in utilization review and claims auditing. Strong analytical skills and proficiency in coding standards are essential.

This position offers a competitive salary range, emphasizing the importance of member care and quality compliance.
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