- CVS Health (Phoenix, AZ)
- … clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Phoenix, AZ)
- …promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this ... role, you'll be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
- Highmark Health (Phoenix, AZ)
- …needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise to design, develop, ... while also being capable of developing technical solutions. The consultant will act as a senior resource within the...the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The… more
- Adelante (Mesa, AZ)
- …degree Job Category Health Care Description POSITION SUMMARY The Behavioral Health Consultant is responsible for the management of psychosocial aspects of ... Behavioral Health Consultant - Mesa, AZ Job Details Job Location...and encourages personal responsibility for health. Provides consultation and co- management in the co-treatment of mental disorders and psychosocial… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …responsible for supporting the clinical staff in selection, implementation, and utilization of medical equipment. The incumbent advises management staff in ... standards of professional service. The incumbent is a professional consultant and advisor on healthcare technology matters to PVAHCS...Management ; HTM has a direct impact on all clinical services provided by PVAHCS by ensuring all medical… more
- CenterWell (Phoenix, AZ)
- …medical guidance and expertise. + Develop, implement and monitor the outcomes of utilization review and disease management programs to meet the quality and ... for achieving results. + Clinical Knowledge: You understand clinical program design, implementation, management /monitoring to support choice in… more
- CVS Health (Phoenix, AZ)
- …relations; customer service or audit experience. Experience in research and analysis of utilization management systems. *Fluent in Spanish, both oral and written ... accuracy and appropriateness of a benefit/administrative denial. Can review a clinical determination and understand rationale for decision. Able to research claim… more