Utilization jobs in Phoenix

Spectrum 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 care costs for the de

CalOptima

Behavioral Health Utilization Management Medical Case ManagerCalOptimaJoin Us in this Amazing OpportunityThe Team You'll JoinWe are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to

tango is a leader in the home health management industry and is preparing for significant growth! Our mission is to deliver innovative, home-based, post-acute solutions through proprietary technology and proven processes. We partner with health plans to provide a comprehensive suite of products and

Sanctuary Recovery Centers

$49,920 - $60,324 /year

Job Title: Utilization Review (UR) Coordinator / Authorization Representative Clinical Experience Preferred – Behavioral Health Employment Type: Full-Time Schedule: In-office, Monday through Friday Position Overview We are seeking a detail-oriented and highly organized Utilization Review (UR) Coordi

CenterWell

Become a part of our caring community Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team th

Sanctuary Recovery Centers

Job Title: Utilization Review (UR) Coordinator / Authorization Representative [Clinical Experience Preferred] – Behavioral Health Employment Type: Full-Time Schedule: In-office, Monday through Friday Position Overview We are seeking a detail-oriented and highly organized Utilization Review (UR) Coor

PwC

Specialty/Competency: Operations Industry/Sector: Health Services Time Type: Full time Travel Requirements: Up to 80% At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs

Humana

Become a part of our caring community The Utilization Management Behavioral Health Professional uses behavioral health knowledge to support the coordination, documentation, and communication of medical services and benefit administration determinations. Reporting to the UMB Manager, the UMB Health P

Position Overview We are seeking a detail-oriented and highly organized Utilization Review (UR) Coordinator / Authorization Representative [clinical experience preferred]. This role is responsible for managing authorizations, ensuring medical necessity documentation, and maintaining compliance with

CommonSpirit Health

Where You’ll Work At the heart of CommonSpirit Health's ministry are the national office departments that provide the foundational support, resources, and expertise that empower local communities to focus on what they do best—caring for patients. Our teams bring together expertise in clinical excell

This is where you change your story… At Meadows we understand that new directions to career advancing, and improvement can be scary, but we are excited to offer you a possible new rewarding chapter with us! Come join us in transforming lives! Who are we? Meadows Behavioral Healthcare is a leader in

Description Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse (UR Nurse) , you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members. The UR Nurse is respo

TriWest Healthcare Alliance

Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation fo

CityPhoenix StateAZ RemoteYES DepartmentNursing Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in compet

Sedgwick

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to

Humana

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 Manag

CityPhoenix StateAZ RemoteYES DepartmentNursing Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in compet

Overview: Looking to be part of something more meaningful? At HonorHealth, you’ll be part of a team, creating a multi-dimensional care experience for our patients. You’ll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can se

PwC

Specialty/Competency: Operations Industry/Sector: Health Services Time Type: Full time Travel Requirements: Up to 80% At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs

Description Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse (UR Nurse) , you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members. The UR Nurse is respo