- PharmaCord (Scottsdale, AZ)
- …experience with relevant disease state experience preferred. Nurseline triage, Call Center Utilization Management , Call Center Case Management , a plus. ... collaborating to share ideas, support, and resources. As a Nurse Advocate you are responsible for contact with program...Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are… more
- Daiichi Sankyo, Inc. (Phoenix, AZ)
- …nurses working under the general direction of the Regional Director of Clinical Nurse Managers. The OCE is responsible for educating HCPs/clinics with infusion and ... strong, long-term relationships with clinical personnelEnsures appropriate and compliant utilization of product and disease state education as it relates… more
- 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
- 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
- CVS Health (Phoenix, AZ)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
- CVS Health (Phoenix, AZ)
- …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... Time_ ). + Previous experience with prior authorization. + Previous experience with utilization management . + Previous experience in an acute care setting. +… 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
- Cognizant (Phoenix, AZ)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Centene Corporation (Phoenix, AZ)
- …to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- CVS Health (Phoenix, AZ)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Sharecare (Phoenix, AZ)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- … nurse independently provides patient-centered and recovery-oriented care, milieu management , and maintains self-awareness while caring for patients living with ... EDRP application. Former EDRP participants ineligible to apply. Responsibilities The Registered Nurse (RN) is responsible and accountable for all elements of the… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …outpatient clinics (CBOC). Responsibilities The Maternity Care Coordinator (MCC) Registered Nurse (RN) is responsible for providing competent, evidence-based care to ... maternal and fetal outcomes. Retrieves statistical data on maternity care and utilization at the local VAMC using Veterans Health Administration (VHA) databases. The… 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)
- …the Phoenix VA Health Care System (PVAHCS), Phoenix, AZ Responsibilities The Registered Nurse (RN) is responsible and accountable for all elements of the nursing ... responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Follows… more
- CVS Health (Phoenix, AZ)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Molina Healthcare (Scottsdale, 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
- Adelante (Mesa, AZ)
- Adult Geriatric Nurse Practitioner Job Details Job Location Adelante Healthcare Mesa - Mesa, AZ Position Type Exempt Education Level NP ( Nurse Practitioner) Job ... Category Health Care Description POSITION SUMMARY The Adult Nurse Practitioner is primarily responsible for providing comprehensive primary health care services… 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 ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more
- Molina Healthcare (Scottsdale, AZ)
- …post-discharge coordination to reduce hospital readmission rates and emergency room utilization . * Performs face-to-face in-person visits in a variety of settings ... states besides home state based on business need. * Collaborates with fellow nurse practitioners to develop best practices to perform work duties efficiently and… more
