Utilization Review Nurse jobs in Phoenix, AZ

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Travel Nurse (RN) - Utilization Review (Case Management)
Don't miss this exciting travel Registered Nurse job opportunity! This is a 13 week travel RN (Nurse)- Case Management (Utilization Review) assignment in...
Desired Experience: RN
Easily apply
Intake Clinician (PRN - Saturday availability)
Assists with ongoing utilization as requested by Utilization Management. Collaborates with Business Office and Utilization Review to ensure that all admissions...
Desired Experience: Time Management
Skilled Inpatient Care Coordinator
When naviHealth is delegated for utilization management review refer requests that cannot. Active Registered Nurse (RN) licensure in the state in which the...
Desired Experience: Case Management, BLS Certification, Home Care, Time Management, RN, Microsoft Powerpoint, Microsoft Office, Conflict Management
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Registered Nurse Case Manager
American Health Group Inc - Mesa, AZ 85210
Nurse Case Manager:. The organization provides precertification, utilization review, case management, disease intervention and patient advocacy services....
Desired Experience: Time Management, RN, Home Care
Easily apply

Medical Review Nurse Auditor - Home-based - Phoenix

Qlarant - Phoenix, AZ
Qlarant has exciting opportunities for Medical Review Nurse Auditors to join our Cerritos, CA based Unified Program Integrity Contractors (UPIC) team....
Desired Experience: CPT-4, RN, Medical Coding Certification
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Initial Clinical Reviewer II (RN)

Magellan Health - 505 reviews - Phoenix, AZ 85034 (Central City area)
Initial clinical reviewers are supported by Physician clinical review staff (MDs) in the utilization management determination process....
Desired Experience: RN, Managed Care

Adult and Children's Healthcare Administrator

Magellan Health - 505 reviews - Phoenix, AZ 85034 (Central City area)
Depending on SBU/product supported, supports goals, contracts, and accreditation requirements of health plan in conducting reviews of clinical interactions and...
Desired Experience: BC/BE, Social Work Certification, RN, Supervising Experience, Managed Care

Quality Review Nurse- ZR

The CORE Institute - 72 reviews - Phoenix, AZ
Clinical review, utilization review, or quality assurance review experience preferred. Must be a licensed Registered Nurse (RN)....
Desired Experience: Time Management, RN, Microsoft Office, Medical Terminology

RN Specialist Clinical Documentation at Osborn Full Time Day...

HonorHealth - 281 reviews - Scottsdale, AZ 85255 (North Scottsdale area)
Conducts, in collaboration with case management, medical record reviews evaluating the utilization of facilities and services for appropriate levels of patient...
Desired Experience: RN

Onsite Nurse Reviewer - Mesa, AZ

Humana - 4,057 reviews - Phoenix, AZ
Conduct admission review, post-discharge calls and discharge planning. Previous experience in utilization management, discharge planning and/or home health or...
Desired Experience: Bilingual, RN, Reliable Transportation, Call Center, Driver's License, Triage

UM Professional

Magellan Health - 505 reviews - Phoenix, AZ 85034 (Central City area)
Collects and analyzes utilization information; If LPN, must work under the direct clinical supervision of a Registered Nurse (RN) Case Manager, Registered Nurse...
Desired Experience: Time Management, RN

Medical Claims Review RN / Registered Nurse

Health Choice - 13 reviews - Phoenix, AZ
Provides assistance to Utilization Review nurses. The Medical Claims Review RN reviews medical records and claims data for acute and subacute levels of care....
Desired Experience: RN

Telephonic Nurse - Clinical Health Assistant (RN)

Accolade, Inc. - Scottsdale, AZ 85255 (North Scottsdale area)
Nursing experience in medical/surgical, triage, case management, telephonic nursing, disease management, discharge planning, care coordination, or utilization...
Desired Experience: RN, Microsoft Powerpoint, Microsoft Office
Easily apply

Utilization Review/Management Coordinator FT and PRN

QUAIL RUN BEHAVIORAL HEALTH - 18 reviews - Phoenix, AZ 85050 (Desert View area)
Review assessment information. Assure tracking of insurance reviews, and that reviews are completed in a timely manner....
Desired Experience: Managed Care
Behavioral Health Home Practice Specialist - Maricopa County...
UnitedHealth Group - 11,448 reviews - Phoenix, AZ 85003
Level Psychologist, or Registered Nurse. 3 years of Managed Care and/or Utilization Review experience in a Managed Care setting is highly preferred with...
Desired Experience: Time Management, RN, Microsoft Office, Managed Care
Oncology Case Manager RN - Telecommute anywhere in USA
UnitedHealth Group - 11,448 reviews - Phoenix, AZ 85003
Oncology, Cancer, Case Manager, Care Coordinator, Utilization Management, Utilization Review, RN, Nurse, Chemotherapy, National Comprehensive Cancer Network,...
Desired Experience: Bilingual, Case Manager Certification, RN, Windows, Managed Care