- CVS Health (Phoenix, AZ)
- …And we do it all with heart, each and every day. **Position Summary** The ** Utilization Management Clinical Nurse Consultant** utilizes clinical ... Arizona Time Zone. **Preferred Qualifications** : + Previous experience with utilization management . + Previous clinical experience in Emergency Department,… more
- Humana (Phoenix, AZ)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- CVS Health (Phoenix, AZ)
- …of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active current ... additional Nursing Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma… more
- CenterWell (Phoenix, AZ)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Dignity Health (Gilbert, AZ)
- …and Responsibilities** Under the general direction of the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is...clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year… more
- Evolent (Phoenix, AZ)
- … Reviewer, Nurse , you will routinely interact with leadership and management staff, other CR's ( Clinical Reviewers), providers, office staff and Field ... culture. **What You'll Be Doing:** Job Description As a Clinical Reviewer, Nurse , you will be a..., you will be a key member of the utilization management team. We can offer you… more
- Evolent (Phoenix, AZ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- Community Health Systems (Tucson, AZ)
- …the Progressive Care Unit at Northwest Medical Center.** **What you'll do:** The Registered Nurse Clinical Nurse Leader participates in increased levels of ... This increased surveillance 28 bed unit offers a 1:4 nurse to patient ratio while providing high quality care...Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient… more
- Community Health Systems (Oro Valley, AZ)
- **$10,000 bonus for eligible, experienced RN's!** **This is a full time Clinical Nurse Leader position working night shift in the Med Surg unit at Oro Valley ... huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate… more
- Community Health Systems (Tucson, AZ)
- …huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate ... are available and properly utilized while maintaining cost-effective resource management . + Facilitates ongoing education and professional development for nursing… more
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