- Sedgwick (Phoenix, AZ)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Review Nurse **PRIMARY PURPOSE** : To monitor team and colleague technical ... related line of business experience in telephonic case management (TCM) and/or utilization review or equivalent combination of education and experience required.… more
- CVS Health (Phoenix, AZ)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Banner Health (Sun City West, AZ)
- …and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the completion of a ... satisfaction, wellbeing and fulfilment of their employees. As a RN Registered Nurse Case Manager of Care Coordination, you will contribute your expertise and… more
- Banner Health (Tucson, AZ)
- …provider networks, and regulatory agencies. Must possess knowledge of case management or utilization review as normally obtained through the completion of a ... environments, and resources that promote a healthy work-life balance. As the Registered Nurse RN Case Manager Care Coordination, you will have the opportunity to… more
- The Cigna Group (Peoria, AZ)
- **Summary** The Nurse Case Management Lead Analyst is an integral member of the Care Management department as part of Evernorth Care Group (ENCG) primary care team. ... on the management of high- and rising-risk, disease burdened members. The Nurse Case Management Lead Analyst utilizes clinical skills to assess, plan, implement,… more
- Banner Health (Phoenix, AZ)
- …and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the completion of a ... and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of the health… more
- Banner Health (Phoenix, AZ)
- …and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the completion of a ... and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of the health… more
- Banner Health (Queen Creek, AZ)
- …and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the completion of a ... and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of the health… more
- HonorHealth (AZ)
- …with the Admitting Department to facilitate patient placement. Assist in the utilization review process and work closely with the Nurse Manager to assess and ... the role and accountability of nursing staff to achieve the highest level of nurse function, aligned with the defined organizational culture. Act as a resource for … more
- Molina Healthcare (Tucson, AZ)
- …role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate ... day-to-day operations that involve clinical HCS staff. Communicates findings to the Supervisor or Manager, HCS Department for resolution. + Maintains a minimal… more