2mo
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Utilization Review Specialist
Tucson, Arizona, United States
OnsitePart Time
Bachelor's degree required; Master's preferred. Prior utilization review experience in psychiatric facility preferred. Current unencumbered clinical license preferred. CPR and CPI preferred. Flexibility for hours and overtime.
1d
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Supervisor, Utilization Management
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$91k-$107k/yr RemoteFull Time
3+ YOE3+ MgmtCurrent RN license, 3+ years healthcare experience, 3+ years supervisory experience, 2+ years utilization review/case management, U.S. citizenship and favorable DoD background investigation required.
InterQual, ICD, DSM, CPT, HCPCS, American Dental codes, Microsoft Office, Microsoft Word, Microsoft Outlook, TriWest Intranet
1w
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Utilization Management Coordinator - PRN
Phoenix, Arizona, United States
OnsitePart Time
2+ YOEBachelor’s in counseling, psychology, or social work required; 2+ years healthcare experience; Level 1 Fingerprint Clearance Card obtainable; strong communication and utilization review skills.
1mo
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Supervisor, Utilization Review (TOC) - Hybrid
Phoenix or Tucson or Chandler or Flagstaff or Arizona
HybridFull Time
2+ YOERequires active Arizona RN license, 2 years direct clinical experience, 1 year utilization review experience, Associate's degree (Bachelor's preferred), proficiency with InterQual and Microsoft Word/Excel, supervisory experience and managed care knowledge preferred.
InterQual, Microsoft Word, Microsoft Excel
2w
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Utilization Review Coordinator
Chandler, Arizona, United States
OnsiteFull Time
2+ YOEClinical experience required or 2+ years working with the facility population; high school diploma required; preferred healthcare degree; preferred clinical licensure; CPR and de-escalation/restraint training.
2mo
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Utilization Management Program Manager-RN
Arizona or Arkansas or Connecticut or Florida or Georgia or Idaho or Indiana or Iowa or Kansas or Kentucky or Louisiana or Michigan or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or Pennsylvania or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or West Virginia or Wisconsin
RemoteFull Time
5+ YOEUnencumbered Oregon RN within 90 days, 1 year clinical nursing plus 4 years health-plan utilization management, experience with managed care, data analysis, quality management, and electronic documentation.
Microsoft Office, EPIC, Clinical Care Advanced
1mo
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Yoeme Managed Care Utilization Manager
Tucson, Arizona, United States
OnsiteFull Time
2+ YOE2+ MgmtOversee utilization review, supervise staff, manage health plan operations; requires UR experience, supervisory experience, Bachelor's in public/business admin, Arizona driver’s license, Level 1 clearance, nontraditional hours.
1d
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Medical Director Utilization Management Oncology
Cerritos or California or Nevada or Arizona or Oregon or Florida
$275k-$325k/yr RemoteFull Time
5+ YOEMedical degree (MD or DO) and oncology board certification; minimum 5 years clinical oncology experience and 2+ years utilization management experience; strong analytical and communication skills; ability to review treatment appropriateness.
3d
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Utilization Management Clinician Behavioral Health
Arizona, United States
$61k-$130k/yr RemoteFull Time
3+ YOEActive unrestricted clinical licensure (LCSW/LMFT/LMSW/LPC/RN),3+ years behavioral health experience, strong assessment and decision-making skills, UM knowledge, ability to work MST/PST and protect sensitive information.
2d
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Utilization Review (UR) Coordinator / Authorization Representative [Clinical Experience Preferred] – Behavioral Health
Phoenix, Arizona, United States
$24-$29/hr OnsiteFull Time
2+ YOE2+ years utilization review or behavioral health administration experience, knowledge of AHCCCS authorization and timely filing, EHR experience, strong communication and organizational skills.
AHCCCS, EHR, InterQual, ASAM
1mo
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Oncology Utilization Review - Remote - 1099 (contract)
Orlando or Arizona or Florida or Minnesota or North Dakota or Oregon or Tennessee or United States
RemoteContract
5+ YOEBoard-certified medical oncologist (MD or DO) with a current medical license in AZ, FL, MN, ND, OR, or TN, 5+ years clinical experience (residency counts), daytime availability, and adherence to HIPAA and company policies.
5d
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Utility Person
Prescott, Arizona, United States
$30/hr OnsiteFull Time
High school diploma or equivalent, valid driver’s license, DOT drug testing, ability to perform gas utility locate, patrol, maintenance, recordkeeping and customer service tasks.
GIS
2mo
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Pt Transition Utilization Coordinator, Full Time, Days/Weekends
Show Low, Arizona, United States
OnsiteFull Time
1+ YOEHigh School diploma; basic computer skills; knowledge of health insurance policies; ability to obtain authorizations; 35+ WPM typing; English proficiency; BLS/CPR within 30 days.
EHR, Computer
1d
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Utilization Management Clinical Reviewer (Remote)
Phoenix or United States
RemoteFull Time
2+ YOEActive clinical license (RN/LPN/LVN or PT/OT/SLP), 2+ years clinical experience, utilization review or case management preferred, knowledge of CMS/NCQA guidelines, strong communication and documentation skills.
Microsoft Office, Milliman Care Guidelines
4w
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RN Case Manager - Utilization Review
Phoenix, Arizona, United States
OnsiteFull Time
3+ YOECurrent unrestricted Arizona RN license, ADN required (BSN preferred), 3+ years acute care clinical experience, prior case management/utilization management experience, ability to apply InterQual/MCG and analyze medical necessity.
InterQual, MCG
4w
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RN Case Manager - Utilization Review
Phoenix, Arizona, United States
OnsiteFull Time
3+ YOECurrent unrestricted Arizona RN license, ADN required (BSN preferred), 3+ years clinical acute care experience, prior case management/utilization management, HCQM or CCM preferred, skilled in medical necessity review and payer communication.
InterQual, MCG, Revenue Cycle Management (RCM)
1w
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Supervisor, Utilization Management RN
Arizona, United States
$102k-$163k/yr OnsiteFull Time
7+ YOE3+ MgmtActive California RN license, 7+ years acute/clinical experience, 2+ years UM/case experience, 3+ years supervisory experience, knowledge of UM regulations, Microsoft Word/Excel proficiency.
Microsoft Word, Microsoft Excel
2w
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Utilization Management RN III
Arkansas or Arizona or Florida or Georgia or Iowa or Illinois or Kansas or Kentucky or Michigan or Minnesota or Missouri or North Dakota or Nebraska or Oklahoma or South Dakota or Tennessee or Texas or Virginia or Wisconsin
$70k-$105k/yr RemoteFull Time
5+ YOEBachelor's or equivalent and 5 years experience beyond degree; active LPN or RN license required (active unrestricted RN required); clinical assessment, UM and appeals experience preferred.
1mo
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Utilization Management Registered Nurse
Alabama or Oklahoma or Ohio or New Mexico or New Jersey or New Hampshire or Nebraska or Montana or Missouri or Mississippi or Maryland or Maine or Louisiana or Kentucky or Kansas or Iowa or Indiana or Idaho or Georgia or Florida or Delaware or Colorado or Arkansas or Arizona or Wyoming or Wisconsin or West Virginia or Washington or Virginia or Vermont or Utah or Texas or Tennessee or South Dakota or South Carolina or Rhode Island or Pennsylvania or United States
$71k-$98k/yr RemoteFull Time
1+ YOECompact RN in state of residence, >1 year clinical RN experience (hospital/SNF/home health/acute), ability to apply medical necessity criteria and complete timely determinations in a remote, metrics-focused role.
Milliman Care Guidelines, Interqual
2mo
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Utilization Management Medical Director - Medical Oncology - Remote anywhere in US
Houston or Chicago or Atlanta or Phoenix or Los Angeles or Saint Louis or San Diego or Dallas or Philadelphia or Seattle
$249k-$373k/yr RemoteFull Time
5+ YOEMD or DO with current medical license; Board Certification in Oncology; 5+ years clinical experience in oncology; NCCN guideline experience; able to support utilization review and case/disease management.
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