- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required more
- Molina Healthcare (Phoenix, AZ)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Molina Healthcare (Phoenix, AZ)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- Banner Health (Mesa, AZ)
- …the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in ... could be the perfect opportunity for you. As the RN Case Manager, you will bring your experience and...pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of… more
- Banner Health (Mesa, AZ)
- …include working in an acute care setting within the past 12 months as a Registered Nurse in the specialty area. Banner Registry and Travel physician practice ... Our Endoscopy Unit maintains 6 procedural rooms, along with utilization of the OR, as needed. Nursing careers are...require a minimum of one year experience as a Registered Nurse in a physician practice or… more
- HonorHealth (Phoenix, AZ)
- …3 years clinical experience in a hospital setting. Required Licenses and Certifications Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... in the maintenance of department logs and databases, department statistics, and utilization review documents according to hospital policy and state/ federal… more
- Banner Health (Sun City, AZ)
- …the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in ... be the opportunity you've been waiting for. As an RN Case Manager, you will contribute your expertise and...pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of… more
- Molina Healthcare (Phoenix, AZ)
- …abuse through the identification of aberrant coding and/or billing patterns through utilization review . * Incorporate leadership and communication skills to work ... care experience. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) license in good standing. **PREFERRED… more
- Banner Health (Mesa, AZ)
- …the community.** Our highly skilled team includes experienced bedside registered nurses, licensed nursing assistants, Neonatologists, NNP, Respiratory Therapist, ... care for the patient population. If you are an RN who loves neonatal care and can provide an...drives high clinical outcomes, excellent experience, and effective resource utilization . The role actively participates in department and facility… more
- 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 ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
- Banner Health (Glendale, AZ)
- …This position provides nursing care under the direction and supervision of a registered nurse and/or licensed physician, and is accountable for the quality ... 2. Contributes to plan of care under direction of registered nurse , including the discharge plan, utilizing...Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the… more
- Banner Health (Mesa, AZ)
- …evidenced-based, high-quality clinical care outcome focused, and solution oriented. The Registered Nurse Associate Director position is a full-time day ... health care advancements and excellent patient care. As the RN Associate Director Neuro PCU, you will bring your...and security benefits. If you are a New Graduate Nurse with less than 12 months of experience, please… more
- Molina Healthcare (Phoenix, AZ)
- …License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) license in good standing. + Utilization Management Certification ... _This position requires an actively licensed Registered Nurse_ **JOB DESCRIPTION** **Job Summary** The mission of Clinical Operations is to drive value through an… more
- Guardian Life (Phoenix, AZ)
- **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding disability by ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
- CVS Health (Phoenix, AZ)
- …skills to coordinate, document and communicate all aspects of the utilization /benefit management program. -Applies critical thinking and knowledge in clinically ... Through the use of care management tools and information/data review , conducts comprehensive evaluation of referred member's needs/eligibility and recommends… more
- Centene Corporation (Phoenix, AZ)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse preferred Pay Range: $26.50 - $47.59 per ... on workplace flexibility. **Must have Arizona LPN license or Compact RN license.** **Position Purpose:** Analyzes all prior authorization requests to determine… more
- Adelante (Phoenix, AZ)
- … Practitioner certificate issued by the Arizona Board of Nursing + Valid Arizona Registered Nurse license + Valid Arizona Advanced Practice license + Valid DEA ... Adult Nurse Practitioner Job Details Job Location Adelante Healthcare...the review of protocols and procedures + Review results of utilization and quality monitoring… more
- Centene Corporation (Phoenix, AZ)
- …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... health management systems according to utilization management policies and guidelines + Works with healthcare...or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers… more
- Centene Corporation (Tempe, AZ)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Conduct review of delegated entities for compliance with quality, service performance ... and utilization , credentialing reviews and medical record audits. Perform community...to quality of care issues. + Audit medical records, review administrative claims and analyze data and interventions for… more