- Molina Healthcare (Chandler, AZ)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …of the clinical risk management program including but not limited to the Peer Review program, torts, claims and the Controlled Substance Inspection Program. The ... more
- Molina Healthcare (Chandler, AZ)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... more
- Molina Healthcare (Chandler, AZ)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more
- Molina Healthcare (Chandler, AZ)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more
- CVS Health (Phoenix, AZ)
- …with some flexibility required to accommodate member's needs. Position Summary Nurse Case Manager is responsible for telephonically assessing, planning, implementing ... more
- CVS Health (Phoenix, AZ)
- …Direct and oversee complex reviews. Ensure timely and accurate reporting of review findings and coordinate with investigative to take appropriate action. Conducts ... more