Top 245 Advocacy manager Jobs in Phoenix, Az

RN Case Manager - Utilization Review
The CORE Institute Specialty Hospital —Phoenix, AZ
- Nursing
- RN License
- Bachelor of Science
- Health savings account
- Health insurance
Quick Apply
6d
Member Service Center Team Manager
Global Credit Union —Glendale, AZ
- $69,557 - $112,677 a year
- 8 hour shift
- Mid-level
- High school diploma or GED
- Experience equivalent to degree accepted
- Health savings account
- Paid holidays
Employee Experience & Inclusion Manager
The RealReal —Phoenix, AZ
- $115,000 - $125,000 a year
- Full-time
- Hybrid work
- Continuous improvement
- Travel
- Senior level
Quick Apply
Autism Services Navigator
TriWest Healthcare Alliance —Phoenix, AZ
- $83,000 - $93,000 a year
- Full-time
- Microsoft Outlook
- RN License
- Computer literacy
- AD&D insurance
- Disability insurance
6d
Social Services Guardian
Salt River Pima-Maricopa Indian Community —Scottsdale, AZ
- $71,866 - $97,015 a year
- Weekends as needed
- Writing skills
- Mid-level
- Residential
- Wellness program
- Health savings account
6d
Patient Education Manager (West)
Rhythm Pharmaceuticals —Phoenix, AZ
- $135,000 - $215,000 a year
- Full-time
- Nursing
- 6 years
- Up to 50% travel
2d
Case Manager
Phoenix Children's Hospital —Phoenix, AZ
- Full-time
- Customer service
- Mid-level
- Children
TPS Client Advocacy and Events Manager
U.S. Bank National Association —Phoenix, AZ
- $133,365 - $156,900 a year
- Full-time
- Mid-level
- Master's degree
- Analysis skills
- Paid holidays
- Disability insurance
PCA Program Coordinator
Downtown Phoenix Inc —Phoenix, AZ
- $60,000 - $65,000 a year
- Microsoft Excel
- Microsoft Outlook
- Marketing
Manager, PEO Client Advocates
Paychex —Phoenix, AZ
- $76,172.73 - $119,000.00 a year
- Full-time
- 3 years
- Finance
- Bachelor's degree
- Paid holidays
- Health insurance
Senior Care Advisor
EverCare Placement —Scottsdale, AZ
- $70,000 - $200,000 a year
- Contract
- Hybrid work
- Background check
- Mid-level
- Residential
- Flexible schedule
Quick Apply
Alliance Concierge - Phoenix
Bilt Rewards —Phoenix, AZ
- $70,000 - $100,000 a year
- Full-time
- Office
- 3 years
- Product management
- Health insurance
- Flexible spending account
Student Services Director - DRS & Testing
Mesa Community College —Mesa, AZ
- $84,346 - $109,650 a year
- 8 hour shift
- School experience
- Experience working with individuals with disabilities
- Office
- Wellness program
- 403(b) matching
CRM Specialist (174264)
Colgate-Palmolive —Scottsdale, AZ
- $96,800 - $137,000 a year
- Hybrid work
- Marketing
- 5 years
- Research
- Profit sharing
- Paid parental leave
Customer Advocacy Manager
Thales —Chandler, AZ
- $89,747 - $161,183 a year
- Full-time
- Remote
- Background check
- Marketing
- 5 years
- Health savings account
- AD&D insurance
Regional Chain Sales Manager-NV, AZ, WA, AK, and HI.
Mast-Jägermeister US —Scottsdale, AZ
- $125,000 - $135,000 a year
- Full-time
- Up to 50% travel
- 5 years
- Merchandising
- Health insurance
- Dental insurance
Quick Apply
Shift Supervisor
Recovery Innovations —Peoria, AZ
- $42 - $43 an hour
- Full-time
- Background check
- LMFT
- 18 years or older
- Health insurance
- Dental insurance
Quick Apply
Senior Recruiter
Wilson Engineers —Tempe, AZ
- $80,000 - $110,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Paid holidays
- Disability insurance
Quick Apply
Creative Lead (174262)
Colgate-Palmolive —Scottsdale, AZ
- $124,000 - $155,000 a year
- Hybrid work
- 6 years
- Bachelor's degree
- Travel
- Profit sharing
- Paid parental leave
Child Welfare Management Consulting Senior Manager
Accenture —Scottsdale, AZ
- $122,700 - $338,300 a year
- Full-time
- System design
- 8 years
- Children
- Paid holidays
- Disability insurance
8d

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RN Case Manager - Utilization Review

The CORE Institute Specialty Hospital -
Phoenix, AZ

Quick Apply

Job Details

6 days ago

Benefits

Health savings account
Health insurance
Employee assistance program
401(k) matching
Food provided

Qualifications

Direct patient care
RN License
Acute care facility experience
Associate's degree
Associate Degree in Nursing

Full Job Description

At The CORE Institute, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:

Competitive Health & Welfare Benefits
Monthly $43 stipend to use toward ancillary benefits
HSA with qualifying HDHP plans with company match
401k plan with company match (Part-time employees included)
Employee Assistance Program that is available 24/7 to provide support
Employee Appreciation Days
Free Lunch Fridays
Closed Holidays

Key Responsibilities:

A Case Manager/Utilization Review Nurse, in collaboration with patients/families, physicians and the interdisciplinary team, provides leadership and advocacy in the coordination of patient-centered care across the continuum to facilitate optimal transitions and progression in care.

Conduct concurrent and retrospective reviews of patient medical records to verify the medical necessity of services provided.
Assess admission criteria and length of stay, applying standardized clinical guidelines such as InterQual or MCG to justify care levels.
Issue pre-authorizations for procedures, medications, and durable medical equipment by providing clinical information to insurance carriers.
Collaborate with physicians and other healthcare providers to discuss patient care plans and ensure alignment with coverage policies.
Facilitate communication between medical staff and payers to resolve issues related to treatment plans and reimbursement.
Identify and refer cases to case management or social work for complex discharge planning needs.
Prepare and submit clinical appeals to insurance companies when services are denied, providing documentation to support medical necessity.
Track and analyze utilization data to identify trends in resource use, care delays, and claim denials for reporting purposes.

EDUCATION

Associate Degree in Nursing (ADN) required,
Bachelor of Science in Nursing (BSN) preferred.

EXPERIENCE

Three to five years of clinical experience in a direct patient care setting within an acute care hospital required.
Previous experience in case management or utilization management required.

REQUIREMENTS

A current and unrestricted Arizona Registered Nurse (RN) license.
Certification in Health Care Quality and Management (HCQM) or as a Certified Case Manager (CCM) credential preferred.

KNOWLEDGE

Medical Necessity Analysis: This skill involves a detailed evaluation of patient medical records. The nurse must critically assess the documented clinical information to determine if the proposed treatments, procedures, and services are medically appropriate and necessary according to established standards.
Payer-Provider Liaison: Acting as a crucial communication link, the nurse must effectively mediate between healthcare providers and insurance payers. This requires translating clinical information into the language of insurance requirements to resolve discrepancies and pre-emptively address potential denials.
Utilization Data Interpretation: This involves collaborating with the Revenue Cycle Management (RCM) team to analyze utilization data to spot trends, such as patterns in claim denials, delays in care, or inefficient use of resources. This analysis helps inform process improvements and strategic reporting within the healthcare facility.

SKILLS

Patient Assessment: Conduct comprehensive assessments of patients' medical, emotional, and social needs to develop individualized discharge plans that ensure continuity of care.
Care Coordination: Collaborate with healthcare providers, including doctors, nurses, and therapists, to create an integrated plan of care that addresses clinical needs, equipment, home care, and other requirements.
Discharge Planning: Determine the appropriate discharge disposition based on factors such as living situation, mobility, cognitive status, and available support systems. This includes deciding whether patients can return home with services or require care in a facility.
Arranging Services: Coordinate necessary post-discharge services, such as home health care, rehabilitation, and durable medical equipment, ensuring that these services are in place before the patient leaves the hospital.
Communication: Maintain clear communication with all parties involved in the patient's care, including insurance providers, to secure coverage for post-discharge services and ensure that receiving providers are informed of the patient's needs and changes in their condition.
Clinical Guideline Application: Applying standardized clinical criteria, such as InterQual or MCG, is a core function. This involves interpreting complex medical information and using these evidence-based guidelines to objectively justify admission, continued stays, and the appropriate level of care.

ABILITIES

Ability to work in a high-stress, fast-paced environment.
Ability to develop relationships with providers, staff, patients, families, and payors.
Ability to work cooperatively and professionally in a team environment.

Licenses & Certifications

Required

Registered Nurse

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Quick Apply

Refine Your Search

advocacy manager jobs in phoenix, az

RN Case Manager - Utilization Review

Member Service Center Team Manager

Employee Experience & Inclusion Manager

Autism Services Navigator

Social Services Guardian

Patient Education Manager (West)

Case Manager

TPS Client Advocacy and Events Manager

PCA Program Coordinator

Manager, PEO Client Advocates

Senior Care Advisor

Alliance Concierge - Phoenix

Student Services Director - DRS & Testing

CRM Specialist (174264)

Customer Advocacy Manager

Regional Chain Sales Manager-NV, AZ, WA, AK, and HI.

Shift Supervisor

Senior Recruiter

Creative Lead (174262)

Child Welfare Management Consulting Senior Manager

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