• Utilization Management Nurse…

    Humana (Phoenix, AZ)
    …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (11/16/25)
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  • Utilization Management Nurse

    CenterWell (Phoenix, AZ)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
    CenterWell (11/22/25)
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  • SNF Utilization Management RN…

    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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (09/12/25)
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  • Disease Management Nurse - Remote

    Sharecare (Phoenix, AZ)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
    Sharecare (10/22/25)
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  • Registered Nurse RN Case Manager Transplant

    Banner Health (Phoenix, AZ)
    …care and/or home care environments, community resources and resource/ utilization management . Must demonstrate critical thinking skills, problem-solving ... networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the… more
    Banner Health (11/19/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Phoenix, AZ)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
    CVS Health (11/19/25)
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  • Registered Nurse - Case Manager

    ERP International (Yuma, AZ)
    …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... databases for community resources, etc. + Integrate CM and utilization management (UM) and integrate nursing case...the certifications below **OR** Possess a Master's Degree in Nurse Case Management from a program accredited… more
    ERP International (10/21/25)
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  • Registered Nurse Supervisor

    Adelante (Phoenix, AZ)
    …stock medications, medical supplies and patient care equipment and/or supplies); + Quality Management (15%) + Assist the Nurse Manager/Director of Nursing to ... Registered Nurse Supervisor Job Details Job Location Adelante Healthcare...position is essential to Adelante's team-based primary care medical home model of care that supports coordinated, patient-centered, comprehensive… more
    Adelante (11/14/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Scottsdale, AZ)
    …chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical...be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and… more
    Molina Healthcare (11/14/25)
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