- BroadPath Healthcare Solutions (Tucson, AZ)
- …+ Minimum 3 years of experience in Managed Care, Provider Office, or Utilization Review organization required. + Knowledge of Commercial, Medicare, and Medi-Cal ... **Overview** BroadPath is seeking a highly motivated and results-oriented ** Utilization Management (UM) Nurse ** . Our ideal...Management (UM) Nurse ** . Our ideal **UM Nurse ** will ensure timely review of referrals,… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- … RN Appeals Coordinator.** This role collaborates with clinical review staff, medical directors/physician reviewers, network physicians, and network facilities to ... Friday; 8:00 AM -5:00 PM CST (Flexible) **Responsibilities** A. Performs necessary review to ensure compliance with HHSC and other regulatory entities + Collaborate:… more
- ERP International (Luke AFB, AZ)
- …and 5:00pm, including a one hour lunch **Core Duties:** - Participate in Utilization Management/Case Management meetings to review and identify opportunities to ... work CM services. - Provide patient referrals. - Interface with the MTF RN Case Manager(s) in the development and implementation of the Case Management Program… more
- Parexel (Phoenix, AZ)
- …reproducible research practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable health professional credentials, ... solutions, and ensure high-quality, compliant data. + Use surveillance tools to review data at an aggregate level, identifying patterns or anomalies to ensure… more
- 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… more
- CHS (Tucson, AZ)
- …HealthTrust Workforce Solutions has partnered with CHS to provide travel nurse opportunities through a nationwide network of caring, compassionate, and inclusive ... your community and care for your neighbors. This community hospital is seeking a highly skilled nurse to join their team for an 8, 10, or 13 week assignment based on… more
- Centene Corporation (Phoenix, AZ)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... and be licensed in Arizona **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and… more
- Humana (Phoenix, AZ)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- Molina Healthcare (Chandler, AZ)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Mesa, AZ)
- … and/or coding experience, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical...a hospital setting, including at least 1 year of utilization review , medical claims review ,… more
