- Centene Corporation (Phoenix, AZ)
- …benefits including a fresh perspective on workplace flexibility. Centene is seeking a ** Clinical Review Nurse ** to join our **Arizona Medicaid team** ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Evolent (Phoenix, AZ)
- …Will work with the Director of UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory of the United ... mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance… more
- Adelante (Phoenix, AZ)
- …Nurses and Medical Assistants and/or Care Coordinators, as assigned, in delivery of clinical care. The Nurse Supervisor will act as liaison with accredited ... Registered Nurse Supervisor Job Details Job Location Adelante Healthcare...clinical team on data collection, health outcomes reporting, clinical audits, and programmatic evaluation. + Review … more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …CC Coordinator possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical ... Shares educational findings, experiences, and ideas with peers. Questions clinical practices for the purpose of providing evidence-based care....Nursing may have opportunity to become registered as a nurse with a state licensing board prior … more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- Summary The primary purpose of the Licensed Practical Nurse (LPN) is to perform assigned duties in a manner that promotes quality health care, positive customer ... documentation according to policy and standards. Recognizes and reports to Registered Nurse (RN) and/or Health Care Provider (HCP) immediately signs and symptoms of… more
- Vighter Medical Group (Mesa, AZ)
- Flight Registered Nurse (RN) - Mesa, AZ Job Details Job Location Mesa, AZ - Mesa, AZ Education Level Registered Nurse (RN) Travel Percentage Up to 100% ... Description Flight Registered Nurse (RN) Summary: Vighter is recruiting healthcare professionals (HCPs)...providers and professional responders. + Application of medical principles, clinical procedures, and techniques. + Alertness and skill in… more
- CVS Health (Phoenix, AZ)
- …1 year of Utilization Management experience in concurrent review or prior authorization. + Strong decision-making skills and clinical judgment in independent ... Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role,...managed care organization (MCO). + Experience in a high-volume clinical call center or prior remote work… more
- CVS Health (Phoenix, AZ)
- …enhance a member's overall wellness through integration. - Through the use of clinical tools and information/data review , conducts an evaluation of member's ... as smooth transition to programs and plans. - Applies clinical judgment to the incorporation of strategies designed to...co-morbid and multiple diagnoses that impact functionality. - Reviews prior claims to address potential impact on current case… more
- CenterWell (Phoenix, AZ)
- …with the ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, ... actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that… more
- Ascension Health (Mesa, AZ)
- …date. + Clinical Documentation Prof. credentialed from the Association of Clinical Documentation Improvement Specialists obtained prior to hire date or job ... Ensures the working DRG and other information are entered in the Clinical Documentation Improvement database. + Initiate and maintain extensive interactions with… more
- Molina Healthcare (Chandler, AZ)
- …review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent… more
- Dignity Health (Phoenix, AZ)
- …oriented, self-motivated, and able to problem solve through critical thinking. Clinical pharmacists work collaboratively with physicians, nurse practitioners, ... nursing staff in the infusion suite, offering patient education, and participating in clinical decision making. They review and create care guidelines, and… more
- Molina Healthcare (Phoenix, AZ)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Chandler, AZ)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Phoenix, AZ)
- JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Chandler, AZ)
- …**Preferred Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Fresenius Medical Center (Chandler, AZ)
- …+ Monitor patients' response to dialysis therapy and report any unusual findings to nurse supervisor. + Obtain vital signs prior to reinfusion; perform all ... dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies, procedures, and training and in compliance… more
- Fresenius Medical Center (Queen Creek, AZ)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of… more
- Dignity Health (Laveen, AZ)
- …efficiency, FMEAS, and root cause analyses and medical staff improvement (eg peer review , OPPE, FPPE). Clinical performance improvement, including case review ... **Job Requirements** **Minimum Education and Experience Required:** + Licensed Registered Nurse , Licensed Clinical Pharmacist, or other Licensed Clinical… more
- Fresenius Medical Center (Phoenix, AZ)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of… more