RN Utilization Review Supervisor - Medicaid
Blue Cross Blue Shield of Arizona
Blue Cross Blue Shield of Arizona is seeking a Utilization Review Supervisor to lead the UR department and ensure medical necessity reviews are attended to effectively. This full-time position is hybrid within Arizona with at least two days required onsite weekly. The ideal candidate will possess direct clinical experience, a relevant associate’s degree, and an active RN license in Arizona. Responsibilities include managing authorizations, team metrics, and delivering departmental reports. #J-18808-Ljbffr Blue Cross Blue Shield of Arizona
- ...PURPOSE OF THE JOB The Utilization Review Supervisor coordinates the activities of the UR department... ...sub-acute medical levels of care for Medicaid Business Segment members. This position... ...State of Arizona as a Registered Nurse (RN) Required Certifications ~ N...SuggestedFull timeWork experience placementRemote work2 days per week1 day per week
- ...Job Description Job Description Job Title: Utilization Review (UR) Coordinator / Authorization Representative [Clinical Experience Preferred... ...Preferred Qualifications Experience working with Medicaid/managed care plans, specifically AHCCCS Knowledge of InterQual...SuggestedFull timeWork at officeLocal areaMonday to Friday
- ...is offering a remote internship opportunity for a Utilization Management Behavioral Health Registered Nurse (RN). This role is part of the DOW SkillBridge Internship... ...military spouses. Interns will conduct clinical reviews, communicate with providers, and document findings...SuggestedRemote jobInternship
$71.1k - $97.8k
Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This remote position involves reviewing PA requests to ensure they meet clinical appropriateness according to Medicare and Medicaid guidelines. You will collaborate with staff...SuggestedRemote job- Utilization Management Coordinator Via Linda Behavioral Hospital is a behavioral health provider serving Scottsdale and the greater Phoenix... ...services. Interface with managed care organizations, external reviewers, and other payors for initial reviews, continued stay reviews...SuggestedFull timeWork at office
- Utilization Management Coordinator Via Linda Behavioral Hospital is a behavioral health provider serving Scottsdale and the greater Phoenix... ...services. Interface with managed care organizations, external reviewers, and other payors for initial reviews, continued stay reviews...Work at officeLocal area
- tango is seeking a Utilization Review Nurse (LPN or RN) to join our remote team. This role processes patient authorization requests and coordinates care to ensure compliance with health care standards. Candidates must have at least two years of nursing experience and be...Remote jobFull time
- The RN Manager, Care Management provides leadership, direction... ...effectively resolves utilization review and denial management issues... ...personnel, contracting staff, house supervisors, risk management, physicians... ...knowledge of Medicare/Medicaid, regulatory compliance mandates...Work at officeLocal area
- ...Room-Main $20k Sign-On Bonus available Required 2 years of RN Circulating Operating Room experience Can be flexible with... ...facilitate quality practice and improve the patient experience. Utilizes the nursing process and evidence-based practice to provide...Relocation packageFlexible hoursShift work
$35 - $40 per hour
...0/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services... ..., or vocational nursing. Current, active nursing license (RN, LPN, or LVN) in good standing with the Arizona Board of...Contract workRemote workFlexible hoursWeekend work- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote jobContract work
- ...in Phoenix, Arizona, to oversee medical review processes ensuring appropriateness of care... ...regulations. Applicants should possess an active RN license and have at least 2 years of... ...and provide clinical resources for utilization management. A background in coding and regulations...
- ...position. Candidates must have strong clinical documentation skills and be eligible for DoD background clearance. This role involves reviewing medical records, identifying quality issues, and supporting quality improvement initiatives while collaborating with Medical...Remote job
- ...Directional Drill experience. The ideal candidate must have at least three years of experience operating excavation equipment in the utility industry. Candidates should have strong technical skills and be physically capable of handling demanding conditions. This role...
$93k - $127.5k
...electrowinning plants in the world. Visit the Bagdad town website to learn more. What You Will Do Promote efficient operations of all utility equipment in a manner that maintains equipment in a safe reliable manner. Directly manage the daily activities and professional...Live inShift workDay shift- ...Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate care and managing health...Full timeContract workWork at officeRemote workWork from homeMonday to Friday
- A stable construction company is seeking a skilled Superintendent to lead field operations for utilities projects in Phoenix, Arizona. This role demands at least 5 years of relevant experience, proficiency in blueprint reading, and a valid driver's license. You will oversee...
- ...Utilization Management Coordinator PRN Quail Run Behavioral Health Hospital in Phoenix is seeking a dynamic and talented UM Coordinator... ...of compassionate, dedicated professionals in our utilization review department. Benefits include: challenging and rewarding work...ReliefLocal area
- Responsibilities Utilization Management Coordinator PRN- As Needed Monday - Friday (Not Remote) Quail Run Behavioral Health Hospital in... ...of compassionate, dedicated professionals in our utilization review department Benefits include: Challenging and rewarding work environment...ReliefLocal areaMonday to Friday
$71.1k - $97.8k
...of our caring community The Utilization Management Registered Nurse uses... ...Compact Registered Nurse (RN) license in your state of residence... ...management/utilization review for a health plan or acute care... .... Health Plan or Medicare / Medicaid Experience. Call center or...Bi-weekly payFull timeTemporary workApprenticeshipRemote workHome office$63.75k - $107k
Join to apply for the Energy and Utility Coordinator role at Maricopa County 21 hours ago Be among the first 25 applicants Join to apply... ...and water conservation opportunities and options Perform, review, and approve utility benchmarking, EPA Energy Star participation...Full timeContract workTemporary workWork at officeLocal area$85k - $92k
...healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical... ...with experience in clinical review, utilization management, or healthcare quality within... ...license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW...Remote jobHourly payWork at officeHome office$113k - $119k
TriWest Healthcare Alliance seeks a Manager for Utilization Management to oversee programs related to prior authorization and inpatient care management. You will lead a team, provide training, and ensure quality assurance in a fully remote position. The ideal candidate...Remote job- ...the United States. For more than 20 years, TEiC has supported utilities and power producers during critical outages and complex turnarounds... ...project estimates using TEiC estimating tools and templates. Review and approve estimates for projects within the area. Lead the...Temporary workFlexible hours
- Universal Hospital Services Inc. in Phoenix is seeking a dynamic UM Coordinator to join our utilization review team. The role involves contacting external case managers for insurance certification and helping the treatment team with discharge planning. The ideal candidate...
$88.2k
...recruiting is human. Every application is reviewed by a real member of our Talent... ...consumercellular.com. Job Summary The HRIS Supervisor owns the ADP HRIS ecosystem, ensuring... ...for end-users to maximize system utilization Ensure data accuracy through audits...Hourly pay16 hoursFull timeWork experience placementWork at officeFlexible hoursShift work- POSITION SUMMARY The Prior Authorization RN is responsible for reviewing and processing medical prior authorization requests to ensure services... ...and providers with issues related to prior authorization, utilization management, and/or case management. Meets internal and...
$85k - $92k
...REQUIRED QUALIFICATIONS (MUST HAVE) Active, unrestricted license: RN Minimum 3+ years clinical experience (med/surg and/or... ...PREFERRED QUALIFICATIONS (HIGHLY DESIRED) Clinical Quality / Utilization Review / Case Review experience Experience with federal or government...Remote jobHourly payDay shift$108.2k - $162.41k
...Education and Research in Phoenix, Arizona, is seeking a dedicated RN Manager for Care Management. This leadership role involves... ...case managers and social workers, resolving issues related to utilization review, and ensuring safe discharge planning. Successful candidates...- ...Cardiopulmonary in the lack there of, the Respiratory Supervisor coordinates and executes the activities... ...to maintain unit or program needs, utilizing evidence based information. The... ...requirements Delivery Conducts huddles in review of department operations, patient care,...Shift workNight shift
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