- CVS Health (Phoenix, AZ)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Community Health Systems (Tucson, AZ)
- …and administration of the activities of clinical review , discharge planning, resource utilization and utilization review . Acts as a liaison between ... , working Day shift in Care Management / Case Management at Northwest Medical Center in Tucson, AZ** **What You'll do:** Coordinates services through an… more
- Datavant (Phoenix, AZ)
- …benchmarking, goal setting, timely execution, and superior leadership. + Strong utilization of SalesForce to include monitoring and documenting member information. + ... Understanding and utilization of P&Ls to assist in reducing cost while...exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its… more
- Adelante (Buckeye, AZ)
- …the behavioral health team (psychiatrist, case manager and behavioral health medical assistant) directly and with primary care providers indirectly. Treatment plans ... aid in making recommendations for a portion of these patients by record review without seeing the patients. The therapist will contact patients at predefined… more
- Banner Health (Tucson, AZ)
- …provider networks, and regulatory agencies. Must possess knowledge of case management or utilization review as normally obtained through the completion of a ... discharge plan and updates to patients, families, and the medical team, as well as delegating tasks to a...pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of… more
- Adelante (Phoenix, AZ)
- …the behavioral health team (psychiatrist, case manager and behavioral health medical assistant) directly and with primary care providers indirectly. Treatment plans ... aid in making recommendations for a portion of these patients by record review without actually seeing the patients. The therapist will contact patients at… more
- Molina Healthcare (Tucson, AZ)
- …role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate ... timely completion. + Actively participates in the Department auditing program to review and communicate findings with staff and identify opportunities for improved… more
- SHI (Phoenix, AZ)
- …and supporting major initiative campaigns to enhance technology deployment and utilization . **Role Description** + Drive retention and growth by identifying ... to align forecasts with sales and supply chain management. + Host Quarterly Business Review and status meetings on a regular cadence. + Engage Account Executives and… more
- CVS Health (Phoenix, AZ)
- …day. **Position Summary:** This Case Manager RN position is with Aetna's National Medical Excellence (NME) team and is a fully remote position. Candidates from any ... is a blended role doing both Case Management and Utilization Management. The RN Case Manager is responsible for...all case management activities with members to evaluate the medical needs of the member to facilitate the member's… more
- Cardinal Health (Phoenix, AZ)
- …the Nephrology field specifically, working with dialysis providers distributing pharmaceutical medical supplies from wholesale. You will meet with buyers detailing ... our service and pricing terms to service pharmaceutical medical supply to their facility. This role will also...seize the identified opportunity, execute strategy. Resulting in additional utilization of the Cardinal Service offering. + Prepare and… more
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