- 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)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… 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
- CVS Health (Phoenix, AZ)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … 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 ... hours available with Holiday,Weekend,and laterotations. + **Required Qualifications** + Registered Nurse + Must have active current and unrestricted RN licensure in… 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
- Centene Corporation (Phoenix, AZ)
- …to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… 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
- CVS Health (Phoenix, AZ)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… 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)
- Summary The Nurse Manager position is located within the Nursing, Geriatrics and Extended Care Services at the Phoenix VA Healthcare System (PVAHCS), Phoenix, AZ. ... Center | VA Phoenix Health Care | Veterans Affairs Responsibilities The Nurse Manager (NM) is the designated first-line supervisory authority and is responsible… 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
- Molina Healthcare (Phoenix, AZ)
- …ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) ... modification of payment decisions. + Serves as a clinical resource for utilization management , CMOs, physicians and member/provider inquiries/appeals. + Provides… 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
- Adelante (Phoenix, AZ)
- Family Nurse Practitioner - West Phoenix Job Details Job Location Adelante Healthcare West Phoenix - Phoenix, AZ Position Type Exempt Description POSITION SUMMARY ... for providing comprehensive primary health care services through the identification, management and/or referral of the health problems and the maintenance of… 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 ... pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of...completion of a bachelor's degree in case management or health care. Requires current Registered … 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
- 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