- 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
- 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
- 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
- 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 (Glendale, AZ)
- …quality management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission ... more
- 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
- 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
- Molina Healthcare (Phoenix, AZ)
- … Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... 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 ... more
- 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
- 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 (Phoenix, AZ)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... more
- 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
- 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