• Care Review Clinician, Inpatient Review (RN)

    Molina Healthcare (Phoenix, AZ)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes… more
    Molina Healthcare (04/12/25)
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  • Senior Medical Director, Network Performance

    Banner Health (Phoenix, AZ)
    …met for our wholly owned and delegated plans in the areas of prior authorization , census management , prospective/concurrent/retro review, and appeals. Care ... Areas of responsibility could include but are not limited to: Utilization management : Leading teams and partnering with Senior leaders to ensure appropriate… more
    Banner Health (04/25/25)
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  • Senior Case Manager

    Cardinal Health (Phoenix, AZ)
    …intake, investigating all patient health insurance benefits, identifying & initiating prior authorization and step therapy reviews, proactively following up ... guidance on the appeals process if needed. + Assist in obtaining insurance, prior authorization , and appeal requirements and outcomes. + Demonstrate expertise in… more
    Cardinal Health (04/29/25)
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  • Medical Assistant (Pediatrics)

    Adelante (Surprise, AZ)
    …with patients to develop self- management goals, provide insurance, referral, and prior authorization support, and may also conduct patient outreach to follow ... + Prepare for the patient appointment by reviewing and updating patient records prior to patient arrival + Interview patient to obtain reason for visit: chief… more
    Adelante (05/06/25)
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  • Pharmacy Technician, Clinical/MTM

    Molina Healthcare (Mesa, AZ)
    …Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization , or pharmacy services access issues. * Articulates ... and state laws. Jobs in this family include those involved in formulary management (such as, reviewing drug/provider utilization patterns and pharmacy costs … more
    Molina Healthcare (05/03/25)
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  • Rehabilitation Manager

    BAYADA Home Health Care (Tucson, AZ)
    …and development of field staff + Ensure accurate and timely case management , including supervision, authorization management and interdisciplinary ... and procedures. Rehab Managers are also accountable for internal case management , field staff evaluation and development. The successful Physical Therapist,… more
    BAYADA Home Health Care (04/02/25)
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  • Senior Sourcing Manager - Meetings & Events

    American Express Global Business Travel (Phoenix, AZ)
    …team members and suppliers of program status. + Review all supplier contracts prior to finalization, ensure both program specific and generic terms and conditions ... and the client, including attrition dates, cancellation policies, etc. Use appropriate authorization and addendum form to ensure consistency and accuracy. + Conduct… more
    American Express Global Business Travel (05/06/25)
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  • Clinical Pharmacist- REMOTE

    Prime Therapeutics (Phoenix, AZ)
    …roles to develop and maintain project and benefit plan testing scenarios including utilization management , specialty and new client offerings + Interpret project ... systems to support benefit coverage decisions and contingent therapy, quantity limits, and prior authorization programs + Develop and maintain point of service… more
    Prime Therapeutics (04/25/25)
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  • UM Administration Coordinator

    Humana (Phoenix, AZ)
    …and/or experience with medical terminology and/or ICD-10 codes + Experience with Utilization Review and/or Prior Authorization , preferably within a ... health first** The UM Administration Coordinator 2 contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied… more
    Humana (05/06/25)
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  • Clinical Account Manager - Georgia PDL - Remote

    Prime Therapeutics (Phoenix, AZ)
    …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... functions, DUR committees and responsibilities. + Supports elevated customer service and prior authorization inquiries specific to assigned accounts. + Manages… more
    Prime Therapeutics (04/24/25)
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