utilization management-rn jobs in Phoenix

Summary of Responsibilities:The utility services manager works with all Avenue5 national suppliers regarding utilities at a property, i.e., utility billing, waste, telecom, Wi-Fi, and anything falling under this purview. This role is responsible for managing the onboarding of all national utility supplier accounts for new and existing properties and...

The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and professional development by conducting regular 1:1s, managing performance reviews, and driving compliance with organizational, state, and federal requirements. The...

Highmark Health is seeking a seasoned Product Management leader for Utilization Management. You will direct strategy, roadmap, and value realization, partnering with UM operations and delivery to shape the UM portfolio and business outcomes.The role requires 7 years in product management and 5 years in leadership, plus deep knowledge of health insurance...

The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and professional development by conducting regular 1:1s, managing performance reviews, and driving compliance with organizational, state, and federal requirements. The...

Become a part of our caring community The Utilization Management Clinical Pharmacist 2 (VSP/PT) is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Utilization Management Clinical Pharmacist 2 (VSP/PT) work assignments are varied and frequently require...

Nurses needed in Scottsdale and North Phoenix!Nurses Network by Quality Home Health Care, one of Arizona’s longest-standing, privately-owned home health agencies is currently seeking dedicated and compassionate healthcare professionals to join our team of skilled home health care providers. The ideal candidate will have a strong commitment to providing...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers,...

Overview Full-time days Make a difference every day as an Amedisys registered nurse case manager Join Amedisys -one of the largest and most trusted home health and hospice companies in the U.S.-where flexibility, purpose and growth come together to help patients heal where they feel most comfortable, at home. Attractive pay $85,800.00 - $95,000.00 What's in...

Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication of medical services and benefit administration determinations. You will report to the Manager of Utilization Management and serve as a member of the One Home/Home Solutions...

Explore opportunities with Casa de la Luz East Valley, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each...

Please visit: https://qts.hrnext.com/JobApplication.aspx?jobpostingkey=e1346c9a-ed74-4443-b175-0d2b3432a1d6 Registered Nurse, Fulltime DUTIES AND RESPONSIBILITIES:Apply specific criteria for admission and re-certification to establish the patient’s eligibility and appropriate levels of care.Assess the impact of the terminal diagnosis on the patient’s...

Company Name: Sun Valley Home Healthcare.About Us:At Sun Valley Home Healthcare, we are committed to delivering exceptional, patient-centered care in the comfort of our patients' homes. We prioritize the well-being and independence of those we serve, offering compassionate, comprehensive home health services. As part of our growing team, you will play a key...

UnitedHealth Group is seeking a Senior Clinical Admin Nurse to support UnitedHealthcare in Phoenix, helping members navigate the health care system and coordinating with clinicians and partners to improve access and reduce costs.The role focuses on case management, education for members, adverse determinations support, and precise documentation for...

Job DescriptionPlease read the following job description thoroughly to ensure you are the right fit for this role before applying.PROJECT ENGINEER (Utilities) - Phoenix, AZThis role of Project Engineer is responsible for preparation of detailed design drawings and contract documents for water and wastewater infrastructure projects involving water supply...

Avenue5 is seeking a utilities services manager to oversee national utility suppliers, onboarding for new properties, and rollout of new programs. You will coordinate Wi‑Fi, waste, telecom, and other services, acting as the primary contact for suppliers while ensuring compliance with applicable laws.Requires a Bachelor’s degree and 3–5 years in...

CVS Health Corporation in Phoenix, AZ is seeking a qualified clinician to coordinate and document utilization/benefit management. The role emphasizes applying medical necessity criteria for child and adolescent members and communicating with providers to ensure appropriate care.You will gather clinical information, render coverage determinations and...

Overview Hospital Name: Banner Rehabilitation Hospital Partnership with Select Medical Position: Case Manager ( RN / SW) Location: Phoenix, AZ Schedule: Per Diem onsite week day coverage needed Compensation: $45.00 per hour Previous experience in hospital or skilled nursing facility Case Management and Discharge Planning required. Our...

Job Summary Manages day-to-day construction activities, including supervision of craft employees and subcontractors. Schedules field activities in coordination with the project schedule. Is responsible for safety, production goals, quality control, and cost control. May supervise one or more craft groups and/or scopes of work. This position includes three...

Incredible Health in Phoenix, AZ seeks a Registered Nurse - Case Management Supervisor to lead and coordinate patient care case management across hospital settings. This RN will oversee case managers, review utilization, and ensure smooth pathways for high-quality outcomes.Join a fast-paced clinical team where leadership, professional development, and...

CVS Health is seeking a licensed RN to join American Health Holding, Inc (AHH) as a remote Case Manager. This telephonic role serves across multiple states for fully and self-insured clients, with virtual training and ongoing support.The position requires strong case management skills, oncology experience, and active licensure. You will collaborate with care...