- 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)
- …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
- Veterans Affairs, Veterans Health Administration (Prescott, AZ)
- Summary Northern Arizona VA Health Care System is looking for a Registered Nurse - Utilization Management to join the Quality & Patient Safety team! ... Responsibilities Duties include, but are not limited to: The Utilization Management Coordinator (UMC) is a registered professional nurse who serves as a… more
- CenterWell (Phoenix, AZ)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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
- Dignity Health (Chandler, AZ)
- …and Responsibilities** Under the general direction of the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to ... use of resources; promote quality patient care; assist with patient care management ; comply with applicable standards and regulations and provide information and… more
- Dignity Health (Gilbert, AZ)
- …and Responsibilities** Under the general direction of the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to ... use of resources; promote quality patient care; assist with patient care management ; comply with applicable standards and regulations and provide information 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
- HonorHealth (AZ)
- …an acute care setting. Required1 year experience in UR/UM or Case Management RequiredLicenses and CertificationsRegistered Nurse (RN) State And/Or Compact State ... -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization of health… 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
- Veterans Affairs, Veterans Health Administration (Tucson, AZ)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care… 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
- Veterans Affairs, Veterans Health Administration (Tucson, AZ)
- Summary The Outpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based outpatient care to assigned patients and oversight of ... the continuum of patient care, patient and family education, patient self- management after discharge, and supporting factors that impact customer satisfaction.… 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
- ERP International (Yuma, AZ)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... databases for community resources, etc. + Integrate CM and utilization management (UM) and integrate nursing case...the certifications below **OR** Possess a Master's Degree in Nurse Case Management from a program accredited… more
- Veterans Affairs, Veterans Health Administration (Tucson, AZ)
- …education, orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates MH knowledge, skills, abilities, ... ###@va.gov for questions/assistance. Responsibilities The Inpatient Mental Health (MH) Registered Nurse (RN) executes their position duties to improve patient and… more