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Registered Nurse (Patient Navigator)

Exceptional Healthcare Inc.
Prescott, AZ

Quick Apply

Job Details

Full-time

Benefits

Dental insurance
Paid time off
Vision insurance
401(k) matching

Qualifications

Utilization review
Electronic health records (EHR) management
RN License
BLS Certification
CMS
Regulatory compliance
HIPAA
Communication platforms
CMS regulatory compliance
InterQual
Utilization management
Resource utilization in healthcare
Health information regulatory compliance

Full Job Description

Become a critical lifeline at our new community hospital!

Exceptional Healthcare is seeking a Patient Navigator (RN) in Prescott, AZ.

Summary:
In this role you will serve as a key clinical liaison combining utilization management, care coordination, and provider support to ensure appropriate patient status determinations, medically necessary admissions, and timely transitions of care. This role operates primarily at the point of entry in the Emergency Department (ED) while conducting concurrent reviews on Inpatient and Observation patients.

The ideal candidate is an experienced RN with strong analytical and communication skills focused on revenue integrity, documentation improvement, and regulatory compliance.

As a vital member of our clinical team, you'll deliver exceptional care while maintaining the highest professional standards.

Why EHC:

Comfortable patient ratios that allow for true patient connection
Greater autonomy, closer team alignment, and genuine connections
Opportunities for a path to clinical leadership
Cross training opportunities
Quicker throughput processes
Less administrative friction and direct communication with leadership
A modern standalone facility with full spectrum Med Lab, Radiology, and Pharmacy support
In-house Respiratory Therapist (24 hr coverage)

What You'll Do

Perform real-time triage and clinical review of Emergency Department patients using standardized criteria (e.g., InterQual) to recommend appropriate patient status (Inpatient vs. Observation).
Collaborate directly with physicians and providers to present clinical data and secure accurate, timely status decisions.
Conduct concurrent utilization reviews and follow-up assessments on admitted Inpatient and Observation patients.
Identify and recommend Clinical Documentation Improvement (CDI) opportunities to accurately reflect patient acuity.
Lead proactive discharge planning and transition coordination with patients, families, and post-acute care providers.
Maintain accurate, timely documentation in the system per regulatory requirements.
Educate and mentor clinical staff on utilization management principles, status criteria, and documentation best practices.
Participate in performance improvement initiatives and demonstrate a team-oriented, solution-focused approach. • Other duties as assigned.

What You'll Need

Education & Experience:

Graduate from an accredited school of nursing; BSN preferred.
Active, unrestricted RN license in the state of Arizona (or compact equivalent).
Minimum 2–3 years of clinical nursing experience (Emergency Department, Critical Care, Case Management, or Utilization Review strongly preferred).

Skills & Knowledge:

Demonstrated proficiency or strong aptitude in applying standardized utilization criteria (InterQual or similar).
Excellent interpersonal and communication skills with the ability to present clinical information confidently to physicians.
Proficient in Electronic Health Records (EHR) and virtual communication platforms.
Strong knowledge of HIPAA, CMS guidelines, and utilization management regulations.

Certifications / Licensing:

Current BLS required. ACLS/PALS preferred.

Training Requirement:

Ability to successfully complete a comprehensive 2-week on-site training program

Shift:

This position is scheduled from 10:00 AM to 10:00 PM, Monday through Saturday, with coverage provided by two staff members.

Why Work With Us

Comprehensive health, dental, and vision insurance
401(k) matching and paid time off
Career growth and leadership development opportunities
State-of-the-art facilities and ongoing education
Supportive team environment focused on excellence
Opportunity to help build a new healthcare facility
Compensation: Competitive hourly rate PLUS night/weekend night hourly pay differentials.

Apply Today! Join our founding team and help establish Exceptional Healthcare as the premier provider of emergency care in our community. Take the next step in advancing your ER nursing career with us.

MaJRMUcLnS

Quick Apply

Refine Your Search

utilization review nurse jobs in prescott az

Registered Nurse (Patient Navigator)

Nurse Practitioner - Prescott

Children's Outpatient Psychiatric Mental Health Nurse Practitioner (PMHNP)

Inpatient Psychiatric Mental Health Nurse Practitioner (PMHNP)

Remote Utilization Review RN or LVN (Inpatient/SNF Team.) Must have CA license.

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

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Why EHC:

What You'll Need

Shift:

This position is scheduled from 10:00 AM to 10:00 PM, Monday through Saturday, with coverage provided by two staff members.

Why Work With Us

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