- PharmaCord (Scottsdale, AZ)
- …experience with relevant disease state experience preferred. Nurseline triage, Call Center Utilization Management , Call Center Case Management , a plus. ... never send a check (electronic or physical) to purchase home office equipment. If you receive any suspicious communication...Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are… 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… 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)
- …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
- Sharecare (Phoenix, AZ)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
- Molina Healthcare (Scottsdale, AZ)
- …(EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, community health or public health ... in home health as a licensed clinician, especially in management of chronic conditions. * Experience with underserved populations facing socioeconomic barriers… 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 ... must be technologically proficient, self-directed, autonomous and experience working from home . Care Management & Waiver Service Auditing experience is… 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
- Evolent (Phoenix, AZ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Banner Health (Phoenix, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... caring for patients with wounds. We use a case management model to help patients navigate through the complex...beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with… more
- Banner Health (Phoenix, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... facilities in the Phoenix Metro area. Exemplars mentioned from the American Nurse Credentialing Center included the robust nursing succession planning and the… 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 ... beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with...completion of a bachelor's degree in case management or health care. Requires current Registered … more
- Adelante (Mesa, AZ)
- Adult Nurse Practitioner - Mesa 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
- Evolent (Phoenix, AZ)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
- Banner Health (Mesa, AZ)
- …to be part of a rapidly growing & expanding team. If you are a New Graduate Nurse with less than 12 months of experience, please visit the main job search page and ... under the Job Type filter, select New Nurse Experience. University Medical Center Phoenix is a nationally...beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with… more
- Banner Health (Phoenix, AZ)
- …ED, Dialysis, Oncology or Telemetry. Must have a working knowledge of care management , resource/ utilization management , and hospital and community resources. ... have achieved this designation four times. As a Registered Nurse RN Transplant Coordinator, your role involves assisting patients...beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with… more
- Banner Health (Phoenix, AZ)
- …patient needs, knowledge of related diagnosis, and complex disease management . General Experience: navigation or complex care coordination/case management ... beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- Banner Health (Phoenix, AZ)
- …o General Experience: navigation or complex care coordination/case management knowledge/experience preferred, clinic/ambulatory experience is helpful, ability to ... beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
