• PharmaCord (Scottsdale, AZ)
    …experience with relevant disease state experience preferred. Nurseline triage, Call Center Utilization Management , Call Center Case Management , a plus. ... never send a check (electronic or physical) to purchase home office equipment. If you receive any suspicious communication...Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are… more
    Upward (08/01/25)
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  • Utilization Management Nurse

    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 (09/12/25)
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  • Utilization Management Nurse

    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
    Humana (10/22/25)
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  • SNF Utilization Management RN…

    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
    Humana (09/12/25)
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  • Disease Management Nurse - Remote

    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
    Sharecare (10/22/25)
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  • Field Nurse Practitioner (Boise, ID)

    Molina Healthcare (Chandler, AZ)
    …receptive including home , nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in non-clinical settings and provide ... 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a home health,...home health as a licensed clinician, especially in management of chronic conditions + Experience with underserved populations… more
    Molina Healthcare (10/18/25)
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  • Field Nurse Practitioner (Pocatello, ID)

    Molina Healthcare (Chandler, AZ)
    …(EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, community health or public health ... in home health as a licensed clinician, especially in management of chronic conditions. * Experience with underserved populations facing socioeconomic barriers… more
    Molina Healthcare (10/17/25)
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  • Case Manager, Registered Nurse - Fully…

    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
    CVS Health (10/15/25)
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  • Adult Geriatric Nurse Practitioner

    Adelante (Mesa, AZ)
    Adult Geriatric Nurse Practitioner Job Details Job Location Adelante Healthcare Mesa - Mesa, 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 (09/28/25)
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  • Clinical Reviewer, Nurse -9am -6pm PST

    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
    Evolent (10/21/25)
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  • Consultant, Nurse Disability I

    Lincoln Financial (Phoenix, AZ)
    …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at ...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position… more
    Lincoln Financial (10/10/25)
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  • Licensed Practical Nurse LPN Observation…

    Banner Health (Phoenix, AZ)
    management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... facilities in the Phoenix Metro area. Exemplars mentioned from the American Nurse Credentialing Center included the robust nursing succession planning and the… more
    Banner Health (10/18/25)
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  • RN Registered Nurse Case Manager Care…

    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 (09/26/25)
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  • Adult Nurse Practitioner

    Adelante (Mesa, AZ)
    Adult Nurse Practitioner - Mesa Job Details Job Location Adelante Healthcare Mesa - Mesa, 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 (09/17/25)
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  • Appeals Nurse

    Evolent (Phoenix, AZ)
    …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
    Evolent (10/11/25)
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  • Licensed Practical Nurse LPN Medical…

    Banner Health (Phoenix, AZ)
    management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... maintain safe quality care? Do you have excellent time management and critical thinking skills? Are you; teamwork oriented,...care under the direction and supervision of a registered nurse and/or licensed physician, and is accountable for the… more
    Banner Health (10/18/25)
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  • RN Registered Nurse Transplant Coordinator

    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 (10/10/25)
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  • Registered Nurse RN Patient Navigator…

    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 (10/08/25)
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  • Medical Director

    Molina Healthcare (Chandler, 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 (10/22/25)
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  • Medical Director (AZ)

    Molina Healthcare (Chandler, 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 (10/17/25)
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