- Veterans Health Administration (Phoenix, AZ)
- …include but not limited to: Patient Aligned Care Team (PACT) Outpatient Staff Registered Nurse ( RN ) is responsible for providing competent, evidence-based ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… more
- CVS Health (Phoenix, AZ)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- CVS Health (Phoenix, AZ)
- …+ Licensed Professional Counselor (LPC) + Licensed Marriage and Family Therapist (LMFT) + Registered Nurse ( RN ) + Associate-level licenses may be considered ... it all with heart, each and every day. **Location:** Remote (Arizona residents only) **Travel:** Occasional travel up to...and adolescents? Join Mercy Care as a Behavioral Health Utilization Management Clinician and become part of a mission-driven… more
- CVS Health (Phoenix, AZ)
- …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... remote role open to candidates with an active RN licensure in the state in which they reside....to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN… more
- Highmark Health (Phoenix, AZ)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- Molina Healthcare (AZ)
- **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state of UTAH or have a compact license._ _This ... Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support,… more
- Prime Therapeutics (Phoenix, AZ)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. +… more
- Sharecare (Phoenix, AZ)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- Centene Corporation (Phoenix, AZ)
- …preferred. Expert of utilization management processes preferred. **License/Certification:** + RN or LPN - Licensed Practical Nurse - State Licensure ... Works with senior management to identify and implement opportunities for improvement. ** Remote position 12-9p CST would the hours Location PST/MST preferably.** +… more
- Centene Corporation (Phoenix, AZ)
- …and Family Therapist (LMFT) required or Licensed Mental Health Professional (LMHP) required or RN - Registered Nurse - State Licensure and/or Compact State ... information from the Operations and Medical Management teams. Assesses and performs review of member clinical records and services related to behavioral health and… more
