- Banner Health (Phoenix, AZ)
- …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... Our Care Coordination staff is seeking a part time RN Case Manager to work closely with...and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review … more
- Banner Health (Phoenix, AZ)
- …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... Apply today. Our Care Coordination staff is seeking an RN Case Manager to work closely with...and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review … more
- CVS Health (Phoenix, AZ)
- …approach to overcome barriers to meet goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in clinically… more
- CVS Health (Phoenix, AZ)
- …preferred in social work, psychology, special education, or counseling, or be a licensed registered nurse . Pay Range The typical pay range for this role is: ... approach to overcome barriers to meet goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal… more
- Dignity Health (Mesa, AZ)
- …high levels of patient satisfaction. The Care Coordinator consistently conducts the utilization review process and the discharge planning process as required ... (A Masters Degree in nursing with a concentration in Case Management can serve as a substitute for the...a fast-paced environment with changing priorities. + Current AZ Registered Nurse license required. **Preferred:** + Prior… more
- Centene Corporation (Tempe, AZ)
- …successful transition of care for members from case management to the utilization management + Review analyzes of activities, costs, operations and forecast ... Develop, implement and maintain compliance with policies and procedures regarding medical case management + Ensure compliance with federal and state regulations and… more
- Marriott (Phoenix, AZ)
- …with Claims department regarding case management. + Collaborate with UNM on utilization review issues. + Refer catastrophic cases in coordination with claims ... Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165...from case management to meet jurisdictional needs. Utilization Review + Provide initial clinical … more
- Banner Health (Phoenix, AZ)
- …their caseload appropriately and not feeling "alone" in the field! We recognize that our nurse case managers are the key to a successful journey with home ... nursing care under the direction and supervision of a registered nurse and/or licensed physician, and is...Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the… more
- Humana (Phoenix, AZ)
- …products including Word, Excel and Outlook **Preferred Qualifications** + Appeals/ Utilization Review /Quality Management experience + Previous claims experience ... a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments… more
- CenterWell (Phoenix, AZ)
- …+ Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and procedures + Human ... and keep records of criteria for admission to service, case assignments, and case management. + Represent...Graduate of an accredited school of nursing and current RN state license in good standing OR a graduate… more