Senior UM Review Nurse - Tempe, AZ

We're hiring a Nurse Supervisor to join our Utilization Review team. You will provide day-to-day oversight and management of the team including queue and volume throughput and staffing. · ...

Clinical Review & Appeals Specialist (RN/LVN) for Medix Healthcare in Tempe, AZ. Evaluates appeals related to insurance denials for air ambulance transports. · ...

Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. · ...

Performs criteria-based concurrent and retrospective utilization review to support efficient use of resources; promote quality patient care. · ...

Under the general direction of the Manager of Utilization Review, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use of resources; promote quality patient care; assist with patient care management; comp ...

We are looking for a Registered Nurse with behavioral health experience to support the State of Arizona by providing compassionate care through virtual assessments and patient support. · Provide monitoring and technical assistance to ensure compliance with contractual obligations ...

The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients' needs. · ...

This position is responsible for timely and accurate claims review and adjudication to avoid penalties, establishing and maintaining records and reports, interacting with claims personnel for review and assessing adjudication of work process, · Monitor, evaluate, and approve or d ...

Adelphi is seeking qualified Registered Nurses to provide services at a facility in Glendale. · Clinically review consults/requests for completeness and appropriateness/utilization review. · ...

The Suicide Mortality Review Program conducts multidisciplinary reviews of suicide deaths to identify system gaps risk factors and prevention opportunities. · Review extract and summarize data from medical behavioral health social service autopsy and law enforcement records. · De ...

Navitas Healthcare LLC seeks an experienced Registered Nurse RN to serve as Suicide Mortality Review Nurse Abstractor. · Competitive pay per hour. · ...

A pharmacist is a licensed individual responsible for all aspects of pharmaceutical care and pharmacy practice. · The role of the Pharmacist is to provide drug information, review for interaction, safety and efficacy, as well as clinical consulting services. · ...

We're building a world of health around every individual — shaping a more connected convenient and compassionate health experience At CVS Health you'll be surrounded by passionate colleagues who care deeply innovate with purpose hold ourselves accountable prioritize safety qualit ...

The Academic Records Coordinator provides administrative and clerical support to the registrar function of the campus. · ...

We are seeking an experienced Registered Nurse to review denied claims, determine medical necessity, and prepare strong clinical appeals. · ...

++The Academic Records Coordinator provides administrative support to the registrar function of the campus. · +,++Assist in disseminating schedules for all student cohorts. · Ensure timely fulfillment of textbooks and supplies. · Maintain accurate student files; resolve missing d ...

Provide online course facilitation for the pre-licensure Workforce Development Programs. · ...

We are seeking a Nursing Instructor to provide online course facilitation for our pre-licensure programs. The ideal candidate will have current RN licensure in California and experience teaching nursing courses using a Learning Management System. · ...

The Medical Support Specialist will determine donor eligibility to donate plasma and manage donor adverse events. · Determine donor eligibility; to include, proper management of informed consent, · AIDS education and confidential self-exclusion, · Medical history interview and ac ...

Banner Home Health is a four-star home care agency with a track record for quality and excellence. As a Home Health Registered Nurse, you will join the Banner Home Health Clinical Team providing exceptional expert care in your community. · Assesses patient physical psychological ...