- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… 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)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... for extended periods, talking on thetelephoneand typing on the computer. + Work from home position:During work hours, Colleagues who are working from home must… 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
- Sharecare (Phoenix, AZ)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… 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
- Adelante (Gila Bend, AZ)
- Family Nurse Practitioner - Gila Bend Job Details Job Location Adelante Healthcare Gila Bend - Gila Bend, AZ Position Type Exempt Education Level NP ( Nurse ... Practitioner) Job Category Health Care Description POSITION SUMMARY The Family Nurse Practitioner is primarily responsible for providing comprehensive primary health… 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 ... must be technologically proficient, self-directed, autonomous and experience working from home . Care Management & Waiver Service Auditing experience is… more
- Evolent (Phoenix, AZ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Banner Health (Phoenix, AZ)
- …networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the ... beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with...completion of a bachelor's degree in case management or health care. Requires current Registered … more
- Banner Health (Phoenix, AZ)
- …to be part of a rapidly growing & expanding team. If you are a New Graduate Nurse with less than 12 months of experience, please visit the main job search page and ... under the Job Type filter, select New Nurse Experience. University Medical Center Phoenix is a nationally...beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with… more
- Banner Health (Phoenix, AZ)
- …ED, Dialysis, Oncology or Telemetry. Must have a working knowledge of care management , resource/ utilization management , and hospital and community resources. ... have achieved this designation four times. As a Registered Nurse RN Transplant Coordinator, your role involves assisting patients...beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with… more
- Banner Health (Phoenix, AZ)
- …patient needs, knowledge of related diagnosis, and complex disease management . General Experience: navigation or complex care coordination/case management ... beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- Banner Health (Phoenix, AZ)
- …has over 730 licensed beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with the University of Arizona ... the patient's plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating… more
- Molina Healthcare (Phoenix, AZ)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Molina Healthcare (Phoenix, AZ)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- Molina Healthcare (Phoenix, AZ)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- CVS Health (Phoenix, AZ)
- …we do it all with heart, each and every day. **Position Summary** The **Case Management Coordinator** is a work from home position with travel required (in ... utilizes skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. They apply critical thinking and knowledge in… more
- HonorHealth (Peoria, AZ)
- …Job Summary The RN's practice is guided by the ANA Standard for Professional Nurse and Code of Ethics. The RN has knowledge of professional nursing principles, ... to manage their illnesses or injuries, explain post-treatment and home care needs; diet, nutrition, and exercise programs; and...RN continues to enhance their knowledge in the nursing management and care of patient problems and conditions as… more
- Sharecare (Phoenix, AZ)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more