Mi Casa Nursing CenterNewCare Manager Assistant - LPN Mi Casa Nursing CenterCare Manager Assistant - LPNMesa, AZ$35–$37Promotes quality care using a collaborative process that coordinates, monitors, and evaluates services according to the needs of and interpersonal contact with patients. Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours.
Mi Casa Nursing CenterNewCase Manager (Registered Nurse/RN) Mi Casa Nursing CenterCase Manager (Registered Nurse/RN)Mesa, AZ$41–$46Promotes quality care using a collaborative process that coordinates, monitors, and evaluates services according to the needs of patients. Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours.
OptumNewPatient Care Manager RN OptumPatient Care Manager RNTucson, AZ$85,196–$127,794 / yearReviews, evaluates, and supervises service delivery to ensure appropriateness of care and utilization of services, equipment, and supplies through activities such as random patient visits, medical record reviews and case conferences. Schedules, prepares for, facilitates, and documents case conference/SOC reports and facilitates effective exchange of information across disciplines especially with adverse findings, changes in patient condition, daily and urgent updates, as necessary.
OptumNewSenior Clinical Quality RN - Hybrid West Valley OptumSenior Clinical Quality RN - Hybrid West ValleyGlendale, AZ$72,800–$130,000 / yearClinical Quality Consultant RN will drive consistency, efficient processes and share best practices, in a collaborative effort with the provider and large or complex groups, designed to facilitate a minimum 4 STAR quality performance. Analyze and evaluate provider structure and characteristics, including EMR utilization, office operations, and personnel to identify the most effective approaches and strategies to improve STARS measure performance.
OptumNewSenior Clinical Quality RN - Hybrid East Valley OptumSenior Clinical Quality RN - Hybrid East ValleyScottsdale, AZ$72,800–$130,000 / yearClinical Quality Consultant RN will drive consistency, efficient processes and share best practices, in a collaborative effort with the provider and large or complex groups, designed to facilitate a minimum 4 STAR quality performance. Analyze and evaluate provider structure and characteristics, including EMR utilization, office operations, and personnel to identify the most effective approaches and strategies to improve STARS measure performance.
Mayo ClinicNewRegistered Nurse - Case Manager Inpatient - RN ED/OBS/ACH *Part Time* Mayo ClinicRegistered Nurse - Case Manager Inpatient - RN ED/OBS/ACH *Part Time*Phoenix, AZ$90,604.80–$136,011.20 / yearArizona: Graduate of an accredited, or those in the candidacy process, baccalaureate nursing program, as recognized by the Accreditation Commission for Education in Nursing (ACEN), Commission on Collegiate Nursing Education (CCNE), National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). The RN Case Manager utilizes the principles of mutual respect, patient/family advocacy and provides leadership within the team of internal partners and outside agencies to facilitate best practices that achieve quality clinical, financial, and patient satisfaction outcomes.
TravelNurseSourceNewTravel Nurse RN - Case Manager - $3,280 to $3,400 per week in Tuba City, AZ TravelNurseSourceTravel Nurse RN - Case Manager - $3,280 to $3,400 per week in Tuba City, AZTuba City, AZ$3,280–$3,400The RN Case Manager works with culturally diverse patient populations and addresses barriers to care including chronic illness, mental health concerns, substance abuse, domestic violence, illiteracy, and limited access to healthcare resources. Facility Overview Tuba City Regional Health Care Corporation (TCRHCC) is a Joint Commission-accredited healthcare facility serving a 4,400-square-mile region across the western Navajo and Hopi Reservations in Northwestern Arizona.
TravelNurseSourceNewTravel Nurse RN - Case Manager - $2,800 to $2,850 per week in Tuba City, AZ TravelNurseSourceTravel Nurse RN - Case Manager - $2,800 to $2,850 per week in Tuba City, AZTuba City, AZ$2,800–$2,850The incumbent will work closely work with Providers, Nurses, Social Workers, Physicians, the PRC department, and all health care providers to ensure implementation of appropriate resources in the fulfillment of utilization goals for the hospital and third-party payors. The Social Worker/RN Case Manager is responsible for utilization review of patient cases in the inpatient and outpatient services departments, and review of medical necessity of referrals to specialty providers for services not normally provided within the facility.
Life Care Center of ScottsdaleNewCase Manager Assistant - LPN Non-Nurse Life Care Center of ScottsdaleCase Manager Assistant - LPN Non-NurseScottsdale, AZPromotes quality care using a collaborative process that coordinates, monitors, and evaluates services according to the needs of and interpersonal contact with patients. Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours.
Mayo ClinicNurse Manager - Utilization Management Mayo ClinicNurse Manager - Utilization ManagementPhoenix, AZ$108,201.60–$162,406.40 / yearThe RN Manager effectively resolves utilization review and denial management issues, provides leadership in resolving psychosocial issues, and removes barriers and complexities for case managers and social workers to effectively facilitate safe discharge planning. Collaborates internally with pre-certification staff, admitting and billing office personnel, contracting staff, house supervisors, risk management, physicians, and specialty departments that impact needs during the inpatient stay and through the provision of an effective, safe discharge.
CVS Health CorpNewUtilization Management Nurse Consultant CVS Health CorpUtilization Management Nurse ConsultantWork At Home, AZ$29.10–$62.32 / hourUtilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Spectrum Healthcare ResourcesRN - Utilization Management Spectrum Healthcare ResourcesRN - Utilization ManagementPhoenix, AZA Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles.
University Health Services IncNewUtilization Review Coordinator University Health Services IncUtilization Review CoordinatorSCOTTSDALE, AZOur modern 120-bed facility offers specialized mental health services and substance use treatment for teens, adults, and older adults experiencing issues such as depression, anxiety, personality disorders and co-occurring addictions. Notice At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skill-set and experience with the best possible career at UHS and our subsidiaries.
Oasis Behavioral HealthUtilization Review Coordinator Oasis Behavioral HealthUtilization Review CoordinatorChandler, Arizona
Acadia Healthcare Co IncUtilization Review Coordinator Acadia Healthcare Co IncUtilization Review CoordinatorChandler, AZLICENSES/DESIGNATIONS/CERTIFICATIONS: Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
TriWest Healthcare AllianceUtilization Clinical Reviewer TriWest Healthcare AllianceUtilization Clinical ReviewerPhoenix, AZRemoteFull timeApplies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.
Alignment Healthcare IncRemote-Manager, Case Management SNP (California RN License Required) Alignment Healthcare IncRemote-Manager, Case Management SNP (California RN License Required)AZRemote$113,332–$169,999 / yearIn this fully remote leadership role, you will oversee a high-performing care management team dedicated to improving outcomes for members with complex and chronic healthcare needs. Monitors activities to support the timeliness of Health Risk Assessment (Initial and Reassessment) completion, Individualized Care Plan (ICP) development and Interdisciplinary Care Team (ICT) delivery for SNP members.
HealthforceNewTravel Registered Nurse Case Management Job HealthforceTravel Registered Nurse Case Management JobTuba City, AZHealthforce is a nationwide travel healthcare staffing agency connecting travel nurses and allied health professionals with high-quality contract assignments across the United States. We specialize in placing clinicians in travel nursing jobs, allied health travel assignments, and local contract opportunities in hospitals, long-term care facilities, and outpatient settings.
Blue Cross and Blue Shield AssociationNewSupervisor, Utilization Review (TOC) - Hybrid Blue Cross and Blue Shield AssociationSupervisor, Utilization Review (TOC) - HybridPhoenix, AZAZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. The Utilization Review Supervisor coordinates the activities of the UR department as they relate to medical necessity reviews, authorizations of inpatient, observation and sub-acute medical levels of care for Medicaid Business Segment members.
Summit Healthcare AssociationNewPt Transition Utilization Coordinator, Full Time, Days/Weekends Summit Healthcare AssociationPt Transition Utilization Coordinator, Full Time, Days/WeekendsShow Low, AZPart timeThis position requires knowledge of general office equipment (including the nurse call system, telephone system, fax machine, copy machine, computer, and commonly used hospital programs) as well as excellent computer, communication, critical thinking, problem solving, leadership, supervisory, interpersonal skills, basic math skills, and the ability to exercise independent judgment. The coordinator assists with identifying and anticipating discharge needs for assigned patients and communicates and collaborates with the interdisciplinary team through verbal and written communications while maintaining strict confidentiality specific to communication, record keeping and coordination of services.
Blue Cross and Blue Shield AssociationBehavioral Health Utilization Mgmt Clinician, Senior Blue Cross and Blue Shield AssociationBehavioral Health Utilization Mgmt Clinician, SeniorPhoenix, AZIn this role, you will: Perform prospective & concurrent utilization reviews and first level determination approvals for members admitted to facilities using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medicare as needed. The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinal criteria across multiple lines of business.
US Department of Health and Human ServicesNurse (Case Management) US Department of Health and Human ServicesNurse (Case Management)Phoenix, AZ$84,363–$127,725 / yearMINIMUM QUALIFICATIONS GS-11: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Managed a caseload of patients with chronic conditions by assessing their needs and creating personalized care plans, adjusting them when situations became more complex. This education must have been accredited by the Commission on Collegiate Nursing Education(external link), Council on Accreditation of Nurse Anesthesia Educational Programs(external link), Accreditation Commission for Midwifery Education(external link), or an accrediting body recognized by the U.S. Department of Education(external link) at the time the degree was obtained.
Phoenix Children's HospitalRN Case Manager Phoenix Children's HospitalRN Case ManagerPhoenix, AZThis position works independently, receiving supervision of work activities from the Lead CM team, Supervisor of Case Management, and Manager of Case Management, and is accountable for the quality of clinical services delivered by both them and community partners, identifying and resolving barriers which may hinder effective patient care. Reviews the patient daily for appropriate patient status level of care and goal length of stay per established Case Management daily prioritization protocol utilizing MCG criteria and communicates goal length of stay to clinical care team, patient, and family.
Lamb CompanyNewRN Case Manager Lamb CompanyRN Case ManagerTuba City, AZ$84–$84NECESSARY QUALIFICATIONS Education: Associate s or Bachelor s Degree in Nursing Certifications/License: A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association throughout employment Experience: Three (3) years of clinical nursing experience with (1) year in an Outpatient/Inpatient setting Demonstrated knowledge of the case management, contract health, and utilization review processes. POSITION SUMMARY Incumbent serves as an Outpatient/Inpatient Nurse Case Manager for TCRHCC and at Sacred Peaks Healthcare Center (SPHC) as the supportive contact for specified groups of identified high risk patients; will specifically focus on specialty clinics that need specific Case Management attention.
BesticaNewRN Case Manager BesticaRN Case ManagerTuba City, AZ$20–$20NECESSARY QUALIFICATIONS Education: Associate s or Bachelor s Degree in Nursing Certifications/License: A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association throughout employment Experience: Three (3) years of clinical nursing experience with (1) year in an Outpatient/Inpatient setting Demonstrated knowledge of the case management, contract health, and utilization review processes. POSITION SUMMARY Incumbent serves as an Outpatient/Inpatient Nurse Case Manager for TCRHCC and at Sacred Peaks Healthcare Center (SPHC) as the supportive contact for specified groups of identified high risk patients; will specifically focus on specialty clinics that need specific Case Management attention.
Tohono O'odham Nation HealthcareNurse Case Manager Tohono O'odham Nation HealthcareNurse Case ManagerSan Simon, AZScope of Work: This position is within the Tohono O'odham Nation Health Care, including Sells Hospital, San Xavier Health Center, Santa Rosa Health Center, and San Simon Health Center, in the Division of Purchased Referred Care as assigned. Comprehensive knowledge of alternative resources, such as Medicare, Medicaid, private insurance, and PRC program eligibilityrequirements, including knowledge of reimbursable insurance procedures andconditions and the ability to interpret provisions of individual health plans andgroup plans.
GlobalPoint HCNewRN Case Manager GlobalPoint HCRN Case ManagerTuba City, AZNECESSARY QUALIFICATIONS Education: Associate s or Bachelor s Degree in Nursing Certifications/License: A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association throughout employment Experience: Three (3) years of clinical nursing experience with (1) year in an Outpatient/Inpatient setting Demonstrated knowledge of the case management, contract health, and utilization review processes. POSITION SUMMARY Incumbent serves as an Outpatient/Inpatient Nurse Case Manager for TCRHCC and at Sacred Peaks Healthcare Center (SPHC) as the supportive contact for specified groups of identified high risk patients; will specifically focus on specialty clinics that need specific Case Management attention.
Summit Healthcare AssociationRN Case Manager - PRN Summit Healthcare AssociationRN Case Manager - PRNShow Low, AZPart timeThis employee must be service oriented and have excellent customer service skills, computer skills, critical thinking skills, problem-solving skills, organizational skills, multitasking skills, professional interpersonal skills, time management skills, the ability to prioritize work, the ability to work in a team, and telephone etiquette. This position requires operational knowledge of all equipment in the Care Resource Management department, including: fax, printers, copy machine, phone systems, and commonly used association-wide computer programs (including Hospital Information Systems, MS Office, e-mail, and internet).
Summit Healthcare AssociationRN Case Manager - Full Time- Day Shift Summit Healthcare AssociationRN Case Manager - Full Time- Day ShiftShow Low, AZPart timeThis employee must be service oriented and have excellent customer service skills, computer skills, critical thinking skills, problem-solving skills, organizational skills, multitasking skills, professional interpersonal skills, time management skills, the ability to prioritize work, the ability to work in a team, and telephone etiquette. This position requires operational knowledge of all equipment in the Care Resource Management department, including: fax, printers, copy machine, phone systems, and commonly used association-wide computer programs (including Hospital Information Systems, MS Office, e-mail, and internet).
Tucson Physician Group HoldingsNurse Practitioner- Primary Care in Tucson, AZ- Northwest Tucson Physician Group HoldingsNurse Practitioner- Primary Care in Tucson, AZ- NorthwestTucson, AZProvide direct Primary Care patient care services in an outpatient clinic setting; augment a physician's ability to provide medical services to patients; perform diagnostic and therapeutic procedures, order lab studies and professional consultations. Demonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
Tucson Physician Group HoldingsNurse Practitioner- Primary Care- Tucson, AZ Foothills Tucson Physician Group HoldingsNurse Practitioner- Primary Care- Tucson, AZ FoothillsTucson, AZProvide direct Primary Care patient care services in an outpatient clinic setting; augment a physician's ability to provide medical services to patients; perform diagnostic and therapeutic procedures, order lab studies and professional consultations. Demonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
Carenest Health ServicesNewRN Case Manager Carenest Health ServicesRN Case ManagerTuba City, AZIncumbent serves as an Outpatient/Inpatient Nurse Case Manager for TCRHCC and at Sacred Peaks Healthcare Center (SPHC) as the supportive contact for specified groups of identified high risk patients; will specifically focus on specialty clinics that need specific Case Management attention. Services provided to the community include comprehensive inpatient/outpatient emergency services, dental and ophthalmology services, orthopedics, OB/GYN, oral surgery, eye surgery and urological procedures.
TeemaGroupNewLVN Quality Assurance/Infection Prevention TeemaGroupLVN Quality Assurance/Infection PreventionFLagstaff, AZ$43–$44Conduct infection control surveillance daily rounds to confirm compliance with individual care plans for residents with infections by facility staff. • Utilizes assessment and scheduling protocol to evaluate quality of training and ensure that staff is adequately trained to meet desired outcomes.
United Surgical Partners InternationalRN Case Manager United Surgical Partners InternationalRN Case ManagerMesa, AZProvides supervision and guidance to other members of the surgical nursing unit; and may be authorized, in the absence of the Director of Inpatient and Case Management Services, to make decisions affecting the nursing unit. The RN Case Managerresponsibilities include: Directs and provides professional nursing care for an assigned group of patients across the age continuum, while complying with the Arizona Nurse Practice Act.
Teema GroupClinical Quality Review Nurse Teema GroupClinical Quality Review NursePhoenix, AZ$41–$44This role focuses on reviewing clinical cases, identifying potential quality or safety concerns, and supporting quality improvement initiatives across a complex healthcare delivery network. This is an excellent opportunity for a licensed clinical professional with experience in clinical review, utilization management, or healthcare quality within health plans, hospital systems, or government-supported programs.
TEEMARN Clinical Quality Reviewer TEEMARN Clinical Quality ReviewerPhoenix, AZ$40–$43This role focuses on reviewing clinical cases, identifying potential quality or safety concerns, and supporting quality improvement initiatives across a complex healthcare delivery network. This is an excellent opportunity for a licensed clinical professional with experience in clinical review, utilization management, or healthcare quality within health plans, hospital systems, or government-supported programs.
EquiliemNurse Practitioner EquiliemNurse PractitionerFlorence, AZ$80–$81 / hourThis role includes assessing, diagnosing, and treating patients; executing physician orders; prescribing medications within the scope of licensure; and coordinating patient care plans. The Advanced Registered Nurse Practitioner (ARNP) is responsible for providing comprehensive healthcare services to inmate/resident populations within a correctional healthcare environment.
Tenet Healthcare CorpNewNurse Practitioner- Primary Care- Tucson, AZ Foothills Tenet Healthcare CorpNurse Practitioner- Primary Care- Tucson, AZ FoothillsTucson, AZProvide direct Primary Care patient care services in an outpatient clinic setting; augment a physician's ability to provide medical services to patients; perform diagnostic and therapeutic procedures, order lab studies and professional consultations. Demonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
Tenet Healthcare CorpNurse Practitioner - Primary Care near Phoenix - Goodyear, Az Tenet Healthcare CorpNurse Practitioner - Primary Care near Phoenix - Goodyear, AzGoodyear, AZDemonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner. Diagnoses, treats and plans appropriate health care for clients as appropriate for specialty; refers clients to physicians and/or outside agencies as required.
Macpower Digital Assets Edge Private LimitedDirector Of Case Management Macpower Digital Assets Edge Private LimitedDirector Of Case ManagementFort Mohave, AZ$118,000–$150,000 / yearCoordinate the integration of social services/case management function into the patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies and healthcare facilities. Coordinates the provision of social services to patients, families, and significant others to enable them to deal with the impact of illness on individual family functioning and to achieve maximum benefits from healthcare services.
Gila River Health CareCase Manager-Case Management-HHK-Sacaton Gila River Health CareCase Manager-Case Management-HHK-SacatonSacaton, AZSummary: The Case Manager will provide comprehensive Case Management for patients as assigned to include, but not limited to: assessing patient's needs; developing, implementing, monitoring, and documenting the progress of the patient throughout their hospitalization in an outside area hospital to meet their care needs prior to discharge. The Case Manager performs Utilization Review of the medical necessity and appropriateness of care using InterQual criteria of patients admitted to Gila River Health Care inpatient unit: assessing patient admissions and continued stay criteria to identify issues that may delay patient discharge and facilitate resolution of these issues.
ADELANTE HEALTHCARE, INC.Family Nurse Practitioner Mobile Float - Goodyear ADELANTE HEALTHCARE, INC.Family Nurse Practitioner Mobile Float - GoodyearGoodyear, AZPhysical demands: While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions. The Family Nurse Practitioner is primarily responsible for providing comprehensive primary health care services through the identification, management and/or referral of the health problems and the maintenance of the client's health by means of preventive care and health promotion.
San Carlos Apache Health Care CorpNewNurse (RN) Case Manager San Carlos Apache Health Care CorpNurse (RN) Case ManagerPeridot, AZManages and oversees care coordination of assigned patient case load to ensure delivery of all covered services identified for continuity of care across all levels of care and involved providers; Serves as primary contact/clinical liaison between referral hospitals, treatment facilities and patients/patient's families to ensure delivery of effective and appropriate treatment in accordance with established plan of care. SCAHC gives preference in hiring to San Carlos Apache Tribal members and other Native Americans in accordance with the San Carlos Apache Tribe's Tribal Preference Policy, as set forth in Section 402 of the Tribe's Human Resources Department Policies and Procedures Manual.
ValenzNewSr. Compliance Specialist - Care Management Programs ValenzSr. Compliance Specialist - Care Management ProgramsPhoenix, AZRemoteOversee and support the organization's multi-state Utilization Management licensing program by tracking licensing requirements across applicable jurisdictions, coordinating license applications and renewals, maintaining supporting documentation, and partnering with operational leaders to ensure ongoing compliance with licensing conditions and regulatory obligations. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification.
Arizona Priority CarePrior Auth RN Arizona Priority CarePrior Auth RNChandler, Arizona$35–$41 / hourReporting to the Director of Clinical Services Operations, the RN plays a crucial role in the Utilization Management process by conducting historical research, identifying appropriate criteria, and drug dosing to prepare cases for UM reviewers. The Prior Authorization Registered Nurse (RN) is responsible for conducting initial clinical reviews of preservice authorization requests, focusing on continuity of care and the proper utilization of services.
Fort Defiance Indian HospitalPsychiatric Nurse Manager (Adolescent Care Unit) Fort Defiance Indian HospitalPsychiatric Nurse Manager (Adolescent Care Unit)Fort Defiance, AZEnsures compliance with the hospital wide Quality Assessment/Performance Improvement (QAPI) Program, Centers for Medicare and Medicaid Services Conditions of Participation, Health Care Financing Administration, and Navajo Area Program requirements and identifies opportunities for client care and client process improvements. Supports the implementation of clinical guidelines that may include, but is not limited to, developing/obtaining appropriate education material for patients to monitor patients health conditions that are consistent with the care process model and developing new services that will improve the status of patients.
Tuba City Regional Health Care CorporationPost Discharge Nurse Tuba City Regional Health Care CorporationPost Discharge NurseTuba City, ArizonaThe incumbent is the expert with regards to technical aspects of his/her profession and is held responsible and accountable for medical necessity review, follow up, education and improvements of TCRHCC health care documentation quality and alignment with ongoing changes regarding payment criteria for all third-party groups. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
Arizona Priority CareNurse Practioner Arizona Priority CareNurse PractionerChandler, AZUnder the supervision of the Vice President – Clinical Services, the Nurse Practitioner (NP) will provider direct patient care to AZPC members to improve outcomes in quality, patient experience, and help mitigate utilization of resources in support of AZPC organizational goals and objectives. Orders, performs, and interprets diagnostic tests and screening evaluations such as lab work, diagnostic imaging, spirometry, ankle/brachial index (ABI) and point of care testing and provides timely follow up communication to patient of results.