- Centene Corporation (Phoenix, AZ)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- CVS Health (Phoenix, AZ)
- …costs are paid by the user up front. **Required Qualifications** * 1 year UM, concurrent review or prior authorization * 5 years of clinical experience ... medical management services that support cost-effective quality care for members. Utilizes clinical skills to coordinate, document and communicate all aspects of the… more
- CVS Health (Phoenix, AZ)
- …outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or prior authorization. + Strong decision-making skills and ... healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Key Responsibilities** + Apply critical thinking… more
- Molina Healthcare (Phoenix, AZ)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... national, state, and local laws and regulatory requirements affecting the medical and clinical staff. MD licenses required for the following states: WA FL, MI, MS,… more