- SR International, Inc. (Phoenix, AZ)
- …obtain their own laptop SOAZ - Posting ID # 5297 - Medical Review Nurse (Local Only/Mostly Remote/Onsite Trainings) Skills Required: *Medical nursing practice, ... times for training once starting position Compliance Items: Active RN License in state of Arizona Fingerprint Clearance Card...medical case management protocols, quality management and utilization review protocols as related to all… more
- Parexel (Phoenix, AZ)
- …reproducible research practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable health professional credentials, ... solutions, and ensure high-quality, compliant data. + Use surveillance tools to review data at an aggregate level, identifying patterns or anomalies to ensure… more
- Dignity Health (Mesa, AZ)
- …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
- Humana (Phoenix, AZ)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- Molina Healthcare (Chandler, AZ)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
- Molina Healthcare (Chandler, AZ)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Banner Health (Mesa, AZ)
- …the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in ... be the opportunity you've been waiting for. As an RN Case Manager, you will contribute your expertise and...that includes the da Vinci Surgical System. Becker's Hospital Review named Banner Desert Medical Center as one of… more
- Banner Health (Phoenix, AZ)
- …the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in ... lives, we want to hear from you. As the RN Case Manager in Care Coordination, you will have...pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of… more
- Banner Health (Phoenix, AZ)
- …the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in ... Step into a role where your compassion and clinical expertise truly matter. As a RN Case Manager on our Care Coordination team, you'll be at the heart of patient… more
- CVS Health (Phoenix, AZ)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Cognizant (Phoenix, AZ)
- …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- CVS Health (Phoenix, AZ)
- …promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this ... partial hospitalization and intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or prior authorization. +… more
- Sedgwick (Phoenix, AZ)
- …to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple business lines; and to ... provide expertise in client specific case management and utilization review requirements and ensure customer satisfaction through the provision of these… more
- Lincoln Financial (Phoenix, AZ)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Banner Health (Scottsdale, AZ)
- …This position provides nursing care under the direction and supervision of a registered nurse and/or licensed physician, and is accountable for the quality ... 2. Contributes to plan of care under direction of registered nurse , including the discharge plan, utilizing...Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the… more
- CVS Health (Phoenix, AZ)
- …non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals ... **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the development and… more
- Highmark Health (Phoenix, AZ)
- …**Preferred** + 5 years of experience with communications + 3 years of experience in Utilization Review + 3 years of experience in Account Support + 1 year ... **Required** + None **Preferred** + PA clinical licensure/certifications such as RN , RD, Pharmacist **Language (Other than English):** None **Travel Requirement:**… more
- Molina Healthcare (Chandler, AZ)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- CVS Health (Phoenix, AZ)
- …difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and Transplant, ... ensuring members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote position offers the… more
- Banner Health (Mesa, AZ)
- …da Vinci surgical robots to our 3D cancer technology. As a Progressive Care RN , the rooms are private and provides continuous cardiac monitoring to all patients in ... and advanced technology that includes the da Vinci Surgical System. Becker's Hospital Review named Banner Desert Medical Center as one of the top 50 busiest… more
