- Humana (Phoenix, AZ)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- CVS Health (Phoenix, AZ)
- …more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... in ER, Med/Surg, and/or Critical care setting + Managed Care experience + Utilization review experience + Experience working with Electronic medical record… more
- CVS Health (Chandler, AZ)
- …3 months. Following training, position is remote with occasional in office requirement.** Utilization Review - Precertification Nurse is responsible for ... telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to… more
- HonorHealth (Scottsdale, AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... in an acute care setting. Required 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse (RN) State And/Or Compact… more
- Lincoln Financial Group (Phoenix, AZ)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Humana (Phoenix, AZ)
- …of our caring community and help us put health first** The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and… more
- Humana (Phoenix, AZ)
- …and ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… more
- ERP International (Luke AFB, AZ)
- … Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... **Overview** ERP International is seeking full time **Registered Nurse - Case Management ** in support...and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case… more
- Banner Health (Mesa, AZ)
- …networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through ... , acute care and/or home care environments, community resources and resource/ utilization management . Must demonstrate critical thinking skills, problem-solving… more
- Adelante (Phoenix, AZ)
- …audits, continuing education, and the review of protocols and procedures + Review results of utilization and quality monitoring and participate in the ... Adult Nurse Practitioner Job Details Job Location Adelante Healthcare...providing comprehensive primary health care services through the identification, management and/or referral of the health problems and the… more
- Adelante (Surprise, AZ)
- …audits, continuing education, and the review of protocols and procedures + Review results of utilization and quality monitoring and participate in the ... Family Nurse Practitioner Float - Surprise Job Details Job...providing comprehensive primary health care services through the identification, management and/or referral of the health problems and the… more
- Banner Health (Mesa, AZ)
- …quality management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission ... field preceptor, an IT specialist, a dedicated scheduler, a nurse preceptor during orientation (available every day to help...feeling "alone" in the field! We recognize that our nurse case managers are the key to a successful… more
- Adelante (Phoenix, AZ)
- …preventive and self- management goals to improve their health. Additionally, this nurse position may provide triage services to patients calling for urgent care ... Registered Nurse - West Phoenix Job Details Job Location...suite (Word, Excel, PowerPoint, Outlook) and experience in Patient Management System + Meet the organization immunization requirement +… more
- Banner Health (Mesa, AZ)
- …networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through ... that includes the da Vinci Surgical System. Becker's Hospital Review named Banner Desert Medical Center as one of...the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse… more
- Banner Health (Phoenix, AZ)
- …networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through ... pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of...the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse… more
- Banner Health (Mesa, AZ)
- …in relocation assistance for those with Endoscopy RN experience!** As the Registered Nurse Manager for the operating room, you will bring your leadership experience ... Our Endoscopy Unit maintains 6 procedural rooms, along with utilization of the OR, as needed. Nursing careers are...when applicable** **.** If you are a New Graduate Nurse with less than 12 months of experience, please… more
- Banner Health (Phoenix, AZ)
- …quality management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission ... 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
- Fresenius Medical Center (Sun Lakes, AZ)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Prime Therapeutics (Phoenix, AZ)
- …+ Escalates medical exception requests to nurse , pharmacist or physician on the utilization review clinical team when further review is necessary. + ... company achieving revenue goals and operational objectives. Responsible for executing utilization management programs on behalf of health plan/payor customers,… more
- CVS Health (Phoenix, AZ)
- …more personal, convenient and affordable. **Position Summary** The Care Management Associate supports comprehensive coordination of medical services including Care ... supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.… more