- Humana (Phoenix, AZ)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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. ... use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring… more
- CVS Health (Phoenix, AZ)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active ... additional Nursing Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma… more
- CenterWell (Phoenix, AZ)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- 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
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- Summary The Dialysis Registered Nurse position is located within the Nursing Specialty Service at he Phoenix VA Health Care System (PVAHCS), in Phoenix, AZ For more ... Center | VA Phoenix Health Care | Veterans Affairs Responsibilities The Registered Nurse is responsible and accountable for all elements of the nursing process when… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …AZ. It is a Level 1a major interdisciplinary teaching facility. The Chief Nurse , Sterile Processing Service is the administrative and accountable official for the ... within the organization. Responsibilities VA offers a comprehensive total rewards package: VA Nurse Total Rewards Duties Include but not limited to: The CN SPS… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …a Nurse Officer of the Day (House Supervisor) and/or management experience preferred. Grade Determinations: The following Scope, Education and Dimension criteria ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Responsibilities… more
- Molina Healthcare (Chandler, AZ)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
- Mayo Clinic (Phoenix, AZ)
- …patient plan of care throughout the continuum of care by ensuring appropriate utilization management , care coordination, resource utilization , and clinical ... outcomes. The RN Case Manager provides leadership through education on case management / utilization management concepts, committee work, research, and… more
- Corning Incorporated (Phoenix, AZ)
- …and time management skills. + Great computer skills and EMR utilization **Desired Qualifications:** + Certified Occupational Health Nurse (COHN | COHN-S) ... Occupational Health Nurse **Date:** Dec 11, 2025 **Location:** Phoenix, AZ,...processing of work-related illnesses or injuries. Ensure effective case management . + Absence management - utilize Corning's… 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 ... pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of...completion of a bachelor's degree in case management or health care. Requires current Registered … more
- Evolent (Phoenix, AZ)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Banner Health (Phoenix, AZ)
- …nursing judgement to support and coordinate the complex needs of patients. The Nurse Navigator is continuously assessing for barriers to care and addressing them by ... at least 2 years in pulmonology, or chronic disease management . Other background that would assist in being successful...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- Dignity Health (Gilbert, AZ)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... skills + Collaborate effectively with multiple stakeholders + Understand how utilization management and case management programs integrate + Ability to… more
- Banner Health (Phoenix, AZ)
- …will serve as primary patient and caregiver contact for education, symptom management , and care plan adherence, coordinate care across inpatient, outpatient, and ... oversee ambulatory detox monitoring, specialty medication administration (Vivitrol), lab management , and medication reconciliation, support efforts to reduce readmissions… more
- Banner Health (Phoenix, AZ)
- …the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and ... 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 effective… more
- Select Medical (Phoenix, AZ)
- …focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with ... Monday - Friday 8-5pm** **_Clinical license as a registered nurse or respiratory therapist or master's in social work...growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge… more
- Molina Healthcare (Chandler, AZ)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Molina Healthcare (Chandler, AZ)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more