• Care Review Clinician, Inpatient…

    Molina Healthcare (Phoenix, AZ)
    …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... more
    Molina Healthcare (01/23/25)
    - Save Job - Related Jobs - Block Source
  • RN Utilization Review

    HonorHealth (Scottsdale, AZ)
    …1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required ... more
    HonorHealth (01/23/25)
    - Save Job - Related Jobs - Block Source
  • Care Manager RN - Weekends (Remote)

    Highmark Health (Phoenix, AZ)
    …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... more
    Highmark Health (01/07/25)
    - Save Job - Related Jobs - Block Source
  • RN Case Manager Care Coordination

    Banner Health (Sun City, AZ)
    …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... more
    Banner Health (01/19/25)
    - Save Job - Related Jobs - Block Source
  • Licensed Practical Nurse LPN Medical…

    Banner Health (Glendale, AZ)
    …quality management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission ... more
    Banner Health (01/25/25)
    - Save Job - Related Jobs - Block Source
  • Medical Claim Review Nurse

    Molina Healthcare (Phoenix, AZ)
    …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... more
    Molina Healthcare (01/25/25)
    - Save Job - Related Jobs - Block Source
  • RN Case Manager Per Diem Sonoran Crossing

    HonorHealth (Phoenix, AZ)
    …3 years clinical experience in a hospital setting. Required Licenses and Certifications Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... more
    HonorHealth (01/20/25)
    - Save Job - Related Jobs - Block Source
  • COE CM Director, ( RN required)

    Molina Healthcare (Phoenix, AZ)
    Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... more
    Molina Healthcare (12/12/24)
    - Save Job - Related Jobs - Block Source
  • RN Clinical Consultant, Claims Shared…

    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 ... more
    Guardian Life (12/20/24)
    - Save Job - Related Jobs - Block Source
  • Case Manager RN - Maricopa County

    CVS Health (Phoenix, AZ)
    …Utilizes skills to coordinate, document and communicate all aspects of the utilization /benefit management program. -Applies critical thinking and knowledge in ... more
    CVS Health (11/27/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Review Nurse - Prior…

    Centene Corporation (Phoenix, AZ)
    …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse preferred Pay Range: $26.50 - $47.59 per ... more
    Centene Corporation (01/25/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Review Nurse - Concurrent…

    Centene Corporation (Phoenix, AZ)
    …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... more
    Centene Corporation (01/25/25)
    - Save Job - Related Jobs - Block Source
  • Adult Nurse Practitioner

    Adelante (Phoenix, AZ)
    … Practitioner certificate issued by the Arizona Board of Nursing + Valid Arizona Registered Nurse license + Valid Arizona Advanced Practice license + Valid DEA ... more
    Adelante (01/21/25)
    - Save Job - Related Jobs - Block Source
  • Quality Improvement Coordinator II

    Centene Corporation (Tempe, AZ)
    …including a fresh perspective on workplace flexibility. **Position Purpose:** Conduct review of delegated entities for compliance with quality, service performance ... more
    Centene Corporation (01/10/25)
    - Save Job - Related Jobs - Block Source