- 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
- 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
- Molina Healthcare (Phoenix, 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 (Phoenix, 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
- 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
- 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)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- 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
- 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 (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
- 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)
- …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
- 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 (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
- 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
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …to established policies and procedures and appropriately refers issues to the charge nurse or other health care professional. Makes observations of subtle changes in ... to prevent injury to self or others in all settings such as utilization of lifting equipment. Promotes and demonstrates principles of proper body mechanics while… 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