- Humana (Phoenix, AZ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Banner Health (Gilbert, AZ)
- …the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and ... utilizes the electronic surveillance partnership in caring for the patient, where remote nurses have the ability to interact with patients via two-way audio-video… more
- Sharecare (Phoenix, AZ)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...the disease management program intervention guidelines. An RN is supervised by an Operations Manager (OM). All… more
- CVS Health (Phoenix, AZ)
- …on weekends and some rotational on-call holiday coverage (URAC and Client Requirements). Utilization Management is a 24/7 operation.** Travel Required up to 5% ... meetings/audits The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible...department + 3+ years inpatient clinical experience as a Registered Nurse + 3+ years of Managed… more
- CVS Health (Phoenix, AZ)
- …weekends and some rotational on-call holiday coverage (URAC and Client Requirements). Utilization Management is a 24/7 operation.** 100% attendance is required ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...with 100% participation during 8:30am-5pm Monday-Friday EST + A Registered Nurse that must hold an unrestricted… 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 ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Guardian Life (Phoenix, AZ)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
- Highmark Health (Phoenix, AZ)
- … - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more
- Banner Health (Phoenix, AZ)
- …we are proud to offer our team members many career and lifestyle choices including remote & hybrid work options. If you're looking to leverage your abilities - you ... and extend our innovation to employment settings by including remote and hybrid opportunities. As a Health Partner, you...(AHCCCS) adult population. You will be working with an RN to manage members in their home setting. This… more