- Humana (Phoenix, AZ)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… 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. ... In this role, you'll be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
- Molina Healthcare (Chandler, AZ)
- …hearing officer during fair hearings as may be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for...officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports… more
- Evolent (Phoenix, AZ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- Community Health Systems (Tucson, AZ)
- …the Progressive Care Unit at Northwest Medical Center.** **What you'll do:** The Registered Nurse Clinical Nurse Leader participates in increased levels of ... 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
- 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
- Community Health Systems (Tucson, AZ)
- …huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate ... are available and properly utilized while maintaining cost-effective resource management . + Facilitates ongoing education and professional development for nursing… more
- 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
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …in the CLC. Documenting and taking corrective action when notified by the CLC management team, charge nurse , or designee of any discrepancies in coding or ... Center, Nursing Service, Phoenix VA Healthcare System in Phoenix, AZ The Registered Nurse Community Living Center (CLC) Minimum Data Set (MDS) Registered Nurse … 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 ... self-insured clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures… 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 ... **Department Name:** Case Mgmt-Hosp **Work Shift:** Day **Job Category:** Clinical Care The future is full of possibilities. At...of a bachelor's degree in case management or health care. Requires current Registered … more
- Banner Health (Phoenix, AZ)
- …**Department Name:** BUMCP Advanced Lung Disease **Work Shift:** Day **Job Category:** Clinical Care At Banner - University Medical Center, we're creating a world ... program in our Advanced Lung Disease Clinic at BUMCP leverages their clinical knowledge, experience, critical thinking, and nursing judgement to support and… 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 ... **Department Name:** Case Mgmt-Hosp **Work Shift:** Day **Job Category:** Clinical Care This position is eligible for a $10,000...completion of a bachelor's degree in case management or health care. Requires current Registered … more
- Mayo Clinic (Phoenix, AZ)
- …by ensuring appropriate utilization management , care coordination, resource utilization , and clinical documentation. The RN Case Manager will function ... outcomes. The RN Case Manager provides leadership through education on case management / utilization management concepts, committee work, research, and… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- Summary The Nurse Manager position is located within the Nursing, Geriatrics and Extended Care Services at the Phoenix VA Healthcare System (PVAHCS), Phoenix, AZ. ... Center | VA Phoenix Health Care | Veterans Affairs Responsibilities The Nurse Manager (NM) is the designated first-line supervisory authority and is responsible… more
- Banner Health (Phoenix, AZ)
- …Phoenix, Arizona **Department Name:** Addiction Medicine **Work Shift:** Day **Job Category:** Clinical Care At Banner - University Medical Center, we're creating a ... will serve as primary patient and caregiver contact for education, symptom management , and care plan adherence, coordinate care across inpatient, outpatient, and… more
- Banner Health (Phoenix, AZ)
- …and clinical support to patients and staff. Uses depth and breadth of clinical management knowledge to ensure the provision of high quality, safe, and cost ... the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change...management as normally demonstrated through two years of clinical management experience relevant to patient population.… more
- Banner Health (Phoenix, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... Arizona **Department Name:** Sam Beh Hlth Ctr-Clinic **Work Shift:** Day **Job Category:** Clinical Care The academic medicine difference. At the center of Banner -… more
- Banner Health (Phoenix, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... Phoenix, Arizona **Department Name:** Internal Medicine **Work Shift:** Day **Job Category:** Clinical Care A rewarding career that fits your life. Those who have… more
- Evolent (Phoenix, AZ)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... accomplishments. **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more