- Molina Healthcare (Chandler, AZ)
- …administrative incentives + Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** ... 3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management +… more
- Highmark Health (Phoenix, AZ)
- …drug utilization reports, and write drug monographs for Committee review to develop the Organization's Drug formulary and/OR provide recommendations for NDC ... dose and duration edits, quantity limits, step-care edits, generic sampling medical policy review and development, member facing outreach initiatives… more
- Fresenius Medical Center (Tucson, AZ)
- …staff scheduling and payroll. PHYSICIANS: + Facilitates the application process for physician privileges and compliance with Fresenius Medical Care Medical ... **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Sonora Quest (Chandler, AZ)
- …one special project identified with department management. Exhibits awareness of medical /legal consequences of professional actions. May assist in new employee ... and specimen integrity. **MINIMUM QUALIFICATIONS** + Bachelor's Degree in medical laboratory science/ medical technology, **OR** + Bachelor's degree… more
- Veterans Affairs, Veterans Health Administration (Prescott, AZ)
- …range of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social ... Summary The Advanced Medical Support Assistant (AMSA) serves as a Clinical...delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure… more
- Sonora Quest (Phoenix, AZ)
- …supplies and materials and assists with inventory management. Ensures efficient utilization of reagents and supplies. Recognizes and provides input towards ... skills. + Must exhibit skills in exceptional customer service, good performance review and passing on-site competency evaluation and /or assessment as defined by… more
- Cognizant (Phoenix, AZ)
- …+ Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. + Excellent problem-solving skill in ... with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or...years' claims processing experience is required. + Knowledge of physician practice and hospital coding, and medical … more
- CenterWell (Prescott, AZ)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Community Health Systems (Oro Valley, AZ)
- …administration of the activities of clinical review , discharge planning, resource utilization and utilization review . **Essential Functions** + Conducts ... patient outcomes. This role involves collaborating with interdisciplinary teams, reviewing medical records for appropriateness and medical necessity, and… 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 ... lives - this could be the opportunity you've been waiting for. Banner - University Medical Center Wound Care and Hyperbaric Medicine Clinic is part of the Wound Care… more