• Director, Physician Leadership…

    Humana (Phoenix, AZ)
    …be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus on our ... vulnerable members. The Director, Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training… more
    Humana (08/21/25)
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  • Registered Nurse - Utilization…

    HonorHealth (AZ)
    …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... high quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation,… more
    HonorHealth (08/22/25)
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  • RN Utilization Review Specialist Per…

    HonorHealth (AZ)
    …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of ... high quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation,… more
    HonorHealth (06/11/25)
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  • Physician OB GYN

    Adelante (Surprise, AZ)
    …growth by involvement in quality improvement programs and the participation in peer review , medical record audits, continuing education, and the review ... Physician OB GYN - Surprise Job Details Job...protocols and procedures + Review results of utilization and quality monitoring and participate in the analysis… more
    Adelante (08/22/25)
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  • Physician Internal Medicine

    Adelante (Goodyear, AZ)
    …growth by involvement in quality improvement programs and the participation in peer review , medical record audits, continuing education, and the review ... Physician Internal Medicine - Goodyear Job Details Job...protocols and procedures + Review results of utilization and quality monitoring and participate in the analysis… more
    Adelante (08/16/25)
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  • Family Medicine Physician

    Adelante (Wickenburg, AZ)
    …growth by involvement in quality improvement programs and the participation in peer review , medical record audits, continuing education, and the review ... Family Medicine Physician - Wickenburg Job Details Level Experienced Job...protocols and procedures + Review results of utilization and quality monitoring and participate in the analysis… more
    Adelante (08/12/25)
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  • Physician Family Practice

    Adelante (Buckeye, AZ)
    …growth by involvement in quality improvement programs and the participation in peer review , medical record audits, continuing education, and the review ... Physician Family Practice - Buckeye Job Details Job...protocols and procedures + Review results of utilization and quality monitoring and participate in the analysis… more
    Adelante (07/16/25)
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  • Medical Director

    Molina Healthcare (Scottsdale, AZ)
    …practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease ... productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy … more
    Molina Healthcare (08/20/25)
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  • Field Medical Director, Pain Management

    Evolent (Phoenix, AZ)
    … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be...within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure… more
    Evolent (08/20/25)
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  • Field Medical Director, Cardiology

    Evolent (Phoenix, AZ)
    … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the… more
    Evolent (08/15/25)
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