- ERP International (Luke AFB, AZ)
- …algorithms, CM software, and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking a full time **Registered Nurse - Case Management ** in support of the56th Medical Group at Luke AFB, AZ… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …of Texas or compact license + 3+ years Nursing experience + 1+ years Utilization Management and Appeals experience + Excellent verbal, written and computer ... to establish the most appropriate course of action + Provides education to nurse and therapist reviewers regarding appeal updates and process changes + Maintains… more
- Humana (Phoenix, AZ)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Phoenix, AZ)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring… more
- CVS Health (Phoenix, AZ)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active ... additional Nursing Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma… more
- CenterWell (Phoenix, AZ)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Phoenix, AZ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …AZ. It is a Level 1a major interdisciplinary teaching facility. The Chief Nurse , Sterile Processing Service is the administrative and accountable official for the ... within the organization. Responsibilities VA offers a comprehensive total rewards package: VA Nurse Total Rewards Duties Include but not limited to: The CN SPS… more
- CVS Health (Phoenix, AZ)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Molina Healthcare (Mesa, AZ)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
- Mayo Clinic (Phoenix, AZ)
- …patient plan of care throughout the continuum of care by ensuring appropriate utilization management , care coordination, resource utilization , and clinical ... outcomes. The RN Case Manager provides leadership through education on case management / utilization management concepts, committee work, research, and… more
- Banner Health (Tucson, AZ)
- …agencies, provider networks, and regulatory agencies. Must possess knowledge of case management or utilization review as normally obtained through the completion ... pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of...of a bachelor's degree in case management or health care. Requires current Registered … more
- Corning Incorporated (Phoenix, AZ)
- …and time management skills. + Great computer skills and EMR utilization **Desired Qualifications:** + Certified Occupational Health Nurse (COHN | COHN-S) ... Occupational Health Nurse **Date:** Dec 11, 2025 **Location:** Phoenix, AZ,...processing of work-related illnesses or injuries. Ensure effective case management . + Absence management - utilize Corning's… more
- Community Health Systems (Tucson, AZ)
- …Progressive Care Unit at Northwest Medical Center.** **What you'll do:** The Registered Nurse Clinical Nurse Leader participates in increased levels of care in ... This increased surveillance 28 bed unit offers a 1:4 nurse to patient ratio while providing high quality care...Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient… more
- Banner Health (Sun City, AZ)
- …networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the ... pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of...completion of a bachelor's degree in case management or health care. Requires current Registered … more
- Banner Health (Phoenix, AZ)
- …networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the ... pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of...completion of a bachelor's degree in case management or health care. Requires current Registered … more
- Evolent (Phoenix, AZ)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Banner Health (Phoenix, AZ)
- …nursing judgement to support and coordinate the complex needs of patients. The Nurse Navigator is continuously assessing for barriers to care and addressing them by ... at least 2 years in pulmonology, or chronic disease management . Other background that would assist in being successful...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- Banner Health (Scottsdale, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... care under the direction and supervision of a registered nurse and/or licensed physician, and is accountable for the...Contributes to plan of care under direction of registered nurse , including the discharge plan, utilizing assessment data and… more
- Community Health Systems (Oro Valley, AZ)
- **$10,000 bonus for eligible, experienced RN's!** **This is a full time Clinical Nurse Leader position working night shift in the Med Surg unit at Oro Valley ... huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate… more
