- 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
- 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)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring… 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
- CVS Health (Phoenix, AZ)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Centene Corporation (Phoenix, AZ)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… 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)
- …in the CLC. Documenting and taking corrective action when notified by the CLC management team, charge nurse , or designee of any discrepancies in coding or ... Center, Nursing Service, Phoenix VA Healthcare System in Phoenix, AZ The Registered Nurse Community Living Center (CLC) Minimum Data Set (MDS) Registered Nurse … more
- Banner Health (Phoenix, AZ)
- …, acute care and/or home care environments, community resources and resource/ utilization management . Must demonstrate critical thinking skills, problem-solving ... networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the… 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
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- Summary The Certified Nurse Practitioner (NP) practices to provide a full range of services emphasizing quality, timeliness, and the advancement of the Veterans ... Affairs (VA) mission. The NP provides advanced clinical practice, consultation, and management . The NP practices to the full extent of their education, training, and… more
- Adelante (Phoenix, AZ)
- …stock medications, medical supplies and patient care equipment and/or supplies); + Quality Management (15%) + Assist the Nurse Manager/Director of Nursing to ... Registered Nurse Supervisor Job Details Job Location Adelante Healthcare...+ Minimum of two (2) years increasingly responsible nursing management , experience preferably in outpatient setting. + Minimum of… more
- Molina Healthcare (Phoenix, AZ)
- …chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical...be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and… more
- Adelante (Phoenix, AZ)
- Womens Health Nurse Practitioner - West Phoenix Job Details Job Location Adelante Healthcare West Phoenix - Phoenix, AZ Position Type Exempt Education Level NP ( ... Nurse Practitioner) Job Category Health Care Description POSITION SUMMARY...obstetrical and gynecological health care services through the identification, management and/or referral of the health problems and the… more
- Adelante (Phoenix, AZ)
- Adult Nurse Practitioner Job Details Job Location Adelante Healthcare West Phoenix - Phoenix, 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
- Molina Healthcare (Phoenix, 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
- Banner Health (Glendale, AZ)
- …the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and ... experienced bedside registered nurses, patient care assistants, Neonatologists, Neonatal Nurse Practitioners, Respiratory Therapists, developmental specialists, IBCLC certified lactation… more
- Banner Health (Phoenix, AZ)
- …care patient with chronic complex conditions in the acute care setting, nurse navigator and/or case management field. Requires excellent organizational skills, ... a High-Risk RN Case Manager on our Complex Case Management Team, you can expect to have a caseload...members identified high risk or at risk for high utilization , cost of care, transition of care and or… more