Top 59 Utilization review nurse Jobs in Phoenix Az

Supervisor, Utilization Review (TOC) - Hybrid
Blue Cross Blue Shield of Arizona —Phoenix, AZ
- Full-time
- Microsoft Word
- Nursing
- RN License
RN Clinical Documentation
HonorHealth —Phoenix, AZ
- Full-time
- Remote
- Nursing
- Medicine
- Anatomy knowledge
11d
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
Registered Nurse RN Patient Navigator Addiction Medicine and Recovery
Banner Health —Phoenix, AZ
- Full-time
- Nursing
- Addiction Medicine
- RN License
1d
Registered Nurse RN Patient Navigator Neurology Clinic
Banner Health —Phoenix, AZ
- Part-time
- Background check
- Nursing
- RN License
- Wellness program
- Employee assistance program
ABA Clinical Reviewer
TriWest Healthcare Alliance —Phoenix, AZ
- $79,000 - $93,000 a year
- Full-time
- Microsoft Outlook
- Customer service
- Computer literacy
- AD&D insurance
- Disability insurance
Procedure Nurse Manager - Cardiac Cath Lab/Endoscopy
Abrazo West Campus —Goodyear, AZ
- $45 - $59 an hour
- Full-time
- Hospital
- HIPAA
- In-person
- Free parking
- Continuing education credits
Quick Apply
Nurse Supervisor (PM/NOC) - Ahwatukee Post Acute
Ahwatukee Post Acute —Phoenix, AZ
- Full-time
- Nursing
- LVN
- RN License
Quick Apply
Case Manager Care Coordination
Banner Health —Phoenix, AZ
- 8 hour shift
- Acute care
- Master of Social Work
- Nursing
3d
Utilization Review Coordinator
Axiom Care —Phoenix, AZ
- Full-time
- Mid-level
- Residential
- Microsoft Office
- AD&D insurance
- Paid holidays
Quick Apply
12d
UR Utilization Review Coordinator
CMC Phoenix —Phoenix, AZ
- $34 - $36 an hour
- Full-time
- Hospital
- Computer literacy
- HIPAA
Quick Apply
Nurse Navigator
Arizona Specialty Hospital (11101) —Phoenix, AZ
- Full-time
- Nursing
- Surgery
- RN License
- Health savings account
- Paid holidays
Registered Nurse - Case Management
ERP International —Luke AFB, AZ
- Online Application
- Background check
- Nursing
- Microsoft Outlook
- Health savings account
- Paid holidays
RN, Case Manager
Banner Health —Phoenix, AZ
- $35.43 - $59.05 an hour
- Full-time
- Remote
- Nursing
- RN License
- BLS Certification
- Health insurance
- Flexible schedule
2d
Registered Nurse - Case Manager Inpatient - RN ED/OBS/ACH *Part Time*
Mayo Clinic —Phoenix, AZ
- $90,604.80 - $136,011.20 a year
- 12 hour shift
- Nursing
- RN License
- BLS Certification
- Health savings account
- Health insurance
Registered Nurse - Case Manager Inpatient - RN
Mayo Clinic —Phoenix, AZ
- $90,604.80 - $136,011.20 a year
- Weekends as needed
- Nursing
- RN License
- Hospital
- Health savings account
- Health insurance
Travel Nurse Patient Logistics
Dignity Health —Phoenix, AZ
- $20 - $80 an hour
- Full-time
- Nursing
- RN License
- Mid-level
10d
Registered Nurse RN Patient Navigator Ortho Spine
Banner Health —Sun City West, AZ
- Full-time
- Nursing
- Surgery
- RN License
- Flexible schedule
3d
Travel RN - Case Management/Utilization Review - Case Management
American Traveler —Phoenix, AZ
- $1,832.58 a week
- Contract
- RN License
- Hospital
- BLS Certification
Quick Apply
RN Care Management Coordinator Pool
Valleywise Health System —Phoenix, AZ
- $49 an hour
- Per diem
- Nursing
- RN License
- English

I want to receive the latest job alert for utilization review nurse in phoenix az

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization review nurse jobs near phoenix az

Supervisor, Utilization Review (TOC) - Hybrid

Blue Cross Blue Shield of Arizona -
Phoenix, AZ

Apply Now

Job Details

Full-time

Qualifications

Microsoft Word
RN License
Spreadsheets
InterQual
Utilization management
Patient care
Associate's degree

Full Job Description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
Onsite: daily onsite requirement based on the essential functions of the job
Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.

This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.

PURPOSE OF THE JOB

The Utilization Review Supervisor coordinates the activities of the UR department as they relate to medical necessity reviews, authorizations of inpatient, observation and sub-acute medical levels of care for Medicaid Business Segment members. This position monitors all authorization processes for meeting timeliness standards, cost effectiveness, and regulatory standards. Oversees the Transition of Care team ensuring members are contacted post hospital discharge within regulatory timeframes and member needs are met.

QUALIFICATIONS

REQUIRED QUALIFICATIONS

Required Work Experience

2 years of direct clinical experience
1 year of experience in utilization review

Required Education

Associate’s Degree in general field of study

Required Licenses

Active, current, and unrestricted license to practice in the State of Arizona as a Registered Nurse (RN)

Required Certifications

PREFERRED QUALIFICATIONS

Preferred Work Experience

1 year of managed care/health plan experience
1 year of Medicaid and Medicare experience

Preferred Education

Bachelor’s Degree in Nursing or related field of study

Preferred Licenses

Preferred Certifications

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

Ensures inpatient authorization requests are completed accurately, thoroughly, and in a timely fashion to meet contractual requirements and ensures all reviews are conducted using InterQual.
Evaluating statistics on department’s volumes, results, including approvals, denials, turnaround times for department and individual staff.
Preparing and delivering reports to department and management staff. Performing audits of case files and staff’s work.
Reviewing and updating department’s policies and desktop procedures.
Manage day to day activity of assigned team. Directly supervises staff including participating in hiring, monitoring and evaluating performance, timecards, staff training.
Complete IRR audits per policy; coach and mentor staff; work with management on employee performance issues.
Monitor phone activity and staff productivity. Ensures team meets budget and performance goals.
Participates in Quality Improvement Projects.
Assists management and others in preparation for audits and other regulatory activities.
Participates in interdepartmental meetings and trainings.
Perform all other duties as assigned
The position has an onsite expectation of 2 days per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.

COMPETENCIES

REQUIRED COMPETENCIES

Required Job Skills

InterQual
Computer skills including MS Word, Excel spreadsheets
Communication skills: oral and written

Required Professional Competencies

Required Leadership Experience and Competencies

PREFERRED COMPETENCIES

Preferred Job Skills

Preferred Professional Competencies

Preferred Leadership Experience and Competencies

Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.

Apply Now

Refine Your Search

utilization review nurse jobs in phoenix az

Supervisor, Utilization Review (TOC) - Hybrid

RN Clinical Documentation

RN Case Manager - Utilization Review

Registered Nurse RN Patient Navigator Addiction Medicine and Recovery

Registered Nurse RN Patient Navigator Neurology Clinic

ABA Clinical Reviewer

Procedure Nurse Manager - Cardiac Cath Lab/Endoscopy

Nurse Supervisor (PM/NOC) - Ahwatukee Post Acute

Case Manager Care Coordination

Utilization Review Coordinator

UR Utilization Review Coordinator

Nurse Navigator

Registered Nurse - Case Management

RN, Case Manager

Registered Nurse - Case Manager Inpatient - RN ED/OBS/ACH Part Time

Registered Nurse - Case Manager Inpatient - RN

Travel Nurse Patient Logistics

Registered Nurse RN Patient Navigator Ortho Spine

Travel RN - Case Management/Utilization Review - Case Management

RN Care Management Coordinator Pool

I want to receive the latest job alert for utilization review nurse in phoenix az

Related Searches

Explore jobs in more locations

PURPOSE OF THE JOB

QUALIFICATIONS

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

COMPETENCIES

Job Seeker Tools

Employer Tools

Browse

Stay Connected