- Cognizant (Phoenix, AZ)
- …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Phoenix, AZ)
- …a meaningful difference in the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a mission-driven team that's ... Monday-Friday 8:00am-5:00pm AZT (No weekends or holidays) Location: 100% Remote (Must have Arizona RN license or...in ER, ICU, or Critical Care preferred. + Managed Care/ Utilization Management experience. + Experience with Claims… more
- Banner Health (AZ)
- …and innovative employment options by offering remote and hybrid work settings. The Registered Nurse RN Medical Management Services is required to ... payers, community agencies, provider networks, and regulatory agencies. MINIMUM QUALIFICATIONS Requires Registered Nurse ( RN ) licensure in the state of… more
- Humana (Phoenix, AZ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CVS Health (Phoenix, AZ)
- …members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role, you'll be at the ... times may vary based on business needs. Location: 100% Remote (US only) **About Us** American Health Holding, Inc....a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
- Molina Healthcare (AZ)
- …care or medical or behavioral health settings. Prior experience in Utilization Management and discharge planning. **Preferred License, Certification, ... Association** Active, unrestricted Certified Case Manager (CCM) Some experience with Utilization Management processes is desirable (InterQual, MCG guidelines) ,… more
- Molina Healthcare (Mesa, AZ)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Insight Global (Phoenix, AZ)
- …assurance processes, identify barriers, and report outcomes to management for continuous improvement. Previously a work from home Remote RN CA RN License ... RNs to work virtually in Phoenix. As the PL RN you will help with transfer center operations to...https://insightglobal.com/workforce-privacy-policy/. Skills and Requirements 3 years experience as an RN in a clinical setting *AZ RN … more
- Somatus (Tucson, AZ)
- …utilizing basic nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management ... telephonically as the need arises. **This is a fully remote role where compact licensure is strongly preferred.** **The...Uses protocols and pathways in line with established disease management and care management programs and approved… more
- Evolent (Phoenix, AZ)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed… more