• Registered Nurse Women's Health…

    Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
    Summary The Registered Nurse Women's Health Quality Coordinator position is located within Ambulatory Care Services at the Phoenix VA Healthcare System (PVHCS) ... Center | VA Phoenix Health Care | Veterans Affairs Responsibilities The Registered Nurse Women's Health Quality Coordinator demonstrates proficiency in practice… more
    Veterans Affairs, Veterans Health Administration (01/16/25)
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  • Care Manager RN - Weekends ( Remote

    Highmark Health (Phoenix, AZ)
    …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
    Highmark Health (01/07/25)
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  • Prior Authorization Specialist RN PRN

    Intermountain Health (Phoenix, AZ)
    …REGISTRATION, LICENSE (*indicates primary source verification requirement) Required: + Active Registered Nurse License Preferred: + Certified Healthcare Access ... Associate (CHAA) EXPERIENCE Required: + Licensed Registered Nurse + Minimum of 2 years'...experience in acute clinical nursing setting + Knowledge of utilization management and case management more
    Intermountain Health (01/18/25)
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  • RN Clinical Consultant, Claims Shared…

    Guardian Life (Phoenix, AZ)
    …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
    Guardian Life (12/20/24)
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  • Health Partner Licensed Master Social Worker…

    Banner Health (Phoenix, AZ)
    …Services (AHCCCS) adult population. You will be working in a partnership with a Registered Nurse to support in their homes. This member population does have ... our team members many career and lifestyle choices including remote & hybrid work options. If you're looking to...to overcome and manage. You will help members reduce utilization , help members coordinate care, and ultimately be able… more
    Banner Health (12/11/24)
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  • Senior Process Improvement Professional

    Humana (Phoenix, AZ)
    …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... project management and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance and appeals +… more
    Humana (01/23/25)
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  • Quality Improvement Coordinator II

    Centene Corporation (Tempe, AZ)
    …of delegated entities for compliance with quality, service performance and utilization , credentialing reviews and medical record audits. Perform community activities ... Committee (QIC). + Document, investigate and resolve formal and informal complaints, risk management and sentinel events related to quality of care issues. + Audit… more
    Centene Corporation (01/10/25)
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