- 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
- ERP International (Luke AFB, AZ)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking a full time **Registered Nurse - Case Management ** in support of the56th Medical Group at Luke AFB, AZ… 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
- CenterWell (Phoenix, AZ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
- Corning Incorporated (Phoenix, AZ)
- …and time management skills. + Great computer skills and EMR utilization **Desired Qualifications:** + Certified Occupational Health Nurse (COHN | COHN-S) ... Occupational Health Nurse **Date:** Jan 9, 2026 **Location:** Phoenix, AZ,...connect the unconnected, drive the future of automobiles, transform at- home entertainment, and ensure the delivery of lifesaving medicines.… more
- Evolent (Phoenix, AZ)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… 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)
- …nursing judgement to support and coordinate the complex needs of patients. The Nurse Navigator is continuously assessing for barriers to care and addressing them by ... at least 2 years in pulmonology, or chronic disease management . Other background that would assist in being successful...beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with… more
- Banner Health (Scottsdale, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... care under the direction and supervision of a registered nurse and/or licensed physician, and is accountable for the...LVN in the specialty area. Employees working for Banner Home Care AZ must possess an Arizona Fingerprint Clearance… 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
- 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
- Humana (Phoenix, AZ)
- …others. **Essential Duties and Responsibilities:** + Review PA requests for home health services, durable medical equipment, outpatient therapies, skilled nursing ... inpatient and subacute activity daily for outcomes related to readmission, utilization , quality of care and provider performance in compliance with Humana/iCare… more
- ZOLL Medical Corporation (Phoenix, AZ)
- …medical device technology company that focuses on the development and manufacturing of Home Sleep Apnea Tests to aid in the diagnosis of respiratory sleep disorders. ... Our core product is the WatchPAT(R)️ family, a revolutionary FDA-cleared portable home sleep apnea test device, that is based on proprietary signal and analysis. 80%… more
- Molina Healthcare (Chandler, AZ)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...hold a compact license. This is a Remote position, home office with internet connectivity of high speed required… more
- CVS Health (Phoenix, AZ)
- …As a CPC, you will collaborate closely with account teams, care management , Regional Analytic Consulting, and key enterprise partners to support customer objectives. ... to: + Deliver forward-thinking clinical insights derived from analyzing clinical utilization patterns and member behavior impact on medical costs. + Recommend… more