- Dignity Health (Mesa, AZ)
- …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Healthfirst (AZ)
- **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review , ... reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems + Allocate, monitor,… more
- Centene Corporation (Phoenix, AZ)
- …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... health management systems according to utilization management policies and guidelines + Works with healthcare...or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers… more
- Adelante (Mesa, AZ)
- …audits, continuing education, and the review of protocols and procedures + Review results of utilization and quality monitoring and participate in the ... Women's Health Nurse Practitioner - Mesa, AZ Job Details Job...- Mesa, AZ Position Type Exempt Education Level NP ( Nurse Practitioner) Job Category Health Care Description POSITION SUMMARY… more
- ERP International (Luke AFB, AZ)
- …Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... **Overview** ERP International is seeking full time **Registered Nurse - Case Management** in support of the56th Medical Group at Luke AFB, AZ… more
- Molina Healthcare (Tucson, AZ)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
- Adelante (Phoenix, AZ)
- Family Nurse Practitioner - West Phoenix Job Details Job...the review of protocols and procedures + Review results of utilization and quality monitoring ... ESSENTIAL SKILLS AND EXPERIENCE + Graduate from an approved Nurse Practitioner school + Nurse Practitioner certificate issued by the Arizona Board of Nursing… 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 ... the happiness, satisfaction, wellbeing and fulfilment of their employees. As the Registered Nurse RN Case Manager Care Coordination, you will have the opportunity to… more
- Banner Health (Gilbert, AZ)
- …and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the completion of a ... to interact with patients via two-way audio-video to assist the bedside nurse with patient care. POSITION SUMMARY This position provides comprehensive care… more
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