- Evolent (Phoenix, AZ)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- Cognizant (Phoenix, AZ)
- …necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and ... as well as timely filing deadlines and processes. + Review clinical denials including but not limited...thinking skills to interpret guidelines of internal policies for clinical determination. + Medical Necessity Reviews can… more
- Banner Health (Phoenix, AZ)
- …Health, we take care of nurses. Nurses take care of everyone. Banner - University Medical Center Phoenix has been recognized on the Becker's Hospital Review 2023 ... "Great hospitals in America" list. These hospitals are renowned for clinical excellence, patient safety, innovation efforts, research and education, patient… more
- Banner Health (Phoenix, AZ)
- …role in the assessments and plans of your patients at Banner University Medical Center Phoenix. Banner University Medical Center Phoenix has been recognized ... on the Becker's Hospital Review 2023 "Great hospitals in America" list. These hospitals...hospitals in America" list. These hospitals are renowned for clinical excellence, patient safety, innovation efforts, research and education,… more
- ERP International (Luke AFB, AZ)
- … Nurse - Case Management** in support of the56th Medical Group at Luke AFB, AZ (https://www.airforcemedicine.af.mil/MTF/Luke/About-Us/) . Apply online today ... Current, full, active, and unrestricted license to practice as a Registered Nurse , any state. Clinical Certification:** Certified Case Manager by Commission… more
- Sunrise Senior Living (Scottsdale, AZ)
- …Sunrise of North Scottsdale **Job ID** 2025-234632 **JOB OVERVIEW** The Wellness Nurse is responsible for monitoring the health and well-being of our residents ... administration, communication with resident support services and families, and maintaining clinical quality assurance while leading and demonstrating the Mission for… more
- CenterWell (Phoenix, AZ)
- …teamwork and providing a positive and welcoming environment for all. The Nurse Practitioner (VSP/PRN) provides health promotion and maintenance through the diagnosis ... of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral...accordance with standards of care. + Follows level of medical care and quality for patients and monitors care… more
- CenterWell (Phoenix, AZ)
- …complaints. + Makes clinical level of care determination based on discussion, medical records, and any other pertinent clinical data. Matches these needs to ... to work every other holiday.** The **Care Manager, Telephonic Nurse ** helps to ensure optimal continuity of care for...Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services +… more
- Banner Health (Scottsdale, AZ)
- …Scottsdale, Arizona **Department Name:** Internal Medicine **Work Shift:** Day **Job Category:** Clinical Care A rewarding career that fits your life. Those who have ... clinic, where you'll be working side by side with medical staff to create a great patient experience. As...care under the direction and supervision of a registered nurse and/or licensed physician, and is accountable for the… more
- Banner Health (Phoenix, AZ)
- …Phoenix, Arizona **Department Name:** Case Mgmt-Hosp **Work Shift:** Day **Job Category:** Clinical Care This position is eligible for a $10,000 sign on bonus. ... for patients as assigned. This position is accountable for clinical quality of Care Coordination services delivered by both...discharge plan and updates to patients, families, and the medical team, as well as delegating tasks to a… more
- CVS Health (Phoenix, AZ)
- …Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care ... Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role,...In this role, you'll be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to… more
- Banner Health (Sun City, AZ)
- …City, Arizona **Department Name:** Case Mgmt-Hosp **Work Shift:** Day **Job Category:** Clinical Care The future is full of possibilities. At Banner Health, we're ... for patients as assigned. This position is accountable for clinical quality of Care Coordination services delivered by both...discharge plan and updates to patients, families, and the medical team, as well as delegating tasks to a… more
- Datavant (Phoenix, AZ)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- BioLife Plasma Services (Phoenix, AZ)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- BioLife Plasma Services (Tempe, AZ)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- Health Advocates Network (Glendale, AZ)
- …of all medical records. *Assist Health Service Administrator with the review of medical files to determine all provided services are documented. ... **Must live 70+ miles from the facility for this opening** The Registered Nurse (RN) plans and provides comprehensive nursing care including, but not limited to,… more
- Humana (Phoenix, AZ)
- …effectively communicate a meaningful narrative with those findings + Proven ability to perform clinical reviews and review medical records + Ability to ... of our caring community and help us put health first** The Senior Clinical Medical /Financial Risk Evaluation Professional is responsible for supporting the… more
- CenterWell (Phoenix, AZ)
- …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience,...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Select Medical (Phoenix, AZ)
- …of medical rehabilitation. They assess patients to determine individual care needs, review medical records and meet with hospital teams to coordinate safe ... **Banner Rehabilitation Hospital - Phoenix downtown** A joint venture with Select Medical & Banner Health Downtown Phoenix, AZ ** Clinical Liaison (RN,… more
- Select Medical (Scottsdale, AZ)
- …of medical rehabilitation. They assess patients to determine individual care needs, review medical records and meet with hospital teams to coordinate safe ... **Overview** **HonorHealth Rehabilitation Hospital** **A joint venture with Select Medical & HonorHealth** Scottsdale, AZ **PRN Clinical Liaison (RN, OT, PT, or… more