NewSenior Liability Claims Adjuster Major Case Unit (California) Berkshire Hathaway GUARD Insurance CompaniesSenior Liability Claims Adjuster Major Case Unit (California)Scottsdale, AZ$100,000–$150,000 / yearThe Senior Liability Adjuster is responsible for conducting office investigations and adjusting complex commercial general liability claims that are largely litigated, with exposures up to and exceeding policy limits within our Major Case Unit. This role may be based out of any of our office locations, including: New York, NY; Parsippany, NJ; Conshohocken, PA; Wilkes‑Barre, PA; Alpharetta, GA; Rosemont, IL; Plano, TX; Scottsdale, AZ; and Rancho Cordova, CA.
NewOperations Processor - Debit Fraud Case Processing U.S. BankOperations Processor - Debit Fraud Case ProcessingTempe, ArizonaKey responsibilities include researching and analyzing claim details, contacting customers to gather additional information as needed, and determining whether cases meet criteria for valid fraud or are eligible for recovery. In addition, certain positions may also be subject to the requirements of FINRA, NMLS registration, Reg Z, Reg G, OFAC, the NFA, the FCPA, the Bank Secrecy Act, the SAFE Act, and/or federal guidelines applicable to an agreement, such as those related to ethics, safety, or operational procedures.
NewMajor Case Liability Adjuster Berkshire Hathaway GUARD Insurance CompaniesMajor Case Liability AdjusterScottsdale, AZ$100,000–$150,000 / yearOverview Good Things Start Here. Good things are happening at Berkshire Hathaway GUARD Insurance Companies-an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway. With supportive leadership, collaborative teams, and opportunities to grow, GUARD is a place where people build meaningful, lon...
Director, Care Management \u0026 Social Work Phoenix Children's HospitalDirector, Care Management \u0026 Social WorkPhoenix, AZThis position manages existing Care Coordination vendor relationships, implements and manages a population health program, and collaborates with other key stakeholders to ensure patients are successfully transitioned to Phoenix Children's Care Navigation programs with the goal of improving clinical outcomes through advocacy, partnership and innovation, while lowering the cost of healthcare. This position is accountable for ensuring coordination of patient information with nursing floor management and ensuring close daily communication, as well as, being responsible for the development and implementation of a comprehensive Care Coordination, specific to Care Management, Utilization Management, and Social Work, designed to ensure the patient/family experience from end-to-end is positive, family-centered, accessible and accurate.
NewClinical Trainer and Auditor - Utilization Management Experience - Remote-AZ Blue Cross Blue Shield of ArizonaClinical Trainer and Auditor - Utilization Management Experience - Remote-AZPhoenix, ArizonaRemoteD.),or RDN (Registered Dietitian Nutritionist), CDCES (Certified Diabetes Care and Education Specialist), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN, OR an active, current, and unrestricted license to practice in the State of Arizona as an LPN. Perform quality audits for Utilization Management activities and medical director determinations to evaluate consistency, accuracy, and compliance in evidence-based clinical decision-making, including inter-rater reliability assessments for Utilization Management as applicable.
NewClinical Trainer and Auditor - Utilization Management Experience - Remote-AZ Blue Cross and Blue Shield AssociationClinical Trainer and Auditor - Utilization Management Experience - Remote-AZPhoenix, AZRemoteD.),or RDN (Registered Dietitian Nutritionist), CDCES (Certified Diabetes Care and Education Specialist), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN, OR an active, current, and unrestricted license to practice in the State of Arizona as an LPN. Perform quality audits for Utilization Management activities and medical director determinations to evaluate consistency, accuracy, and compliance in evidence-based clinical decision-making, including inter-rater reliability assessments for Utilization Management as applicable.
Regional Manager - Water Management Solutions Mueller Water Products, Inc.Regional Manager - Water Management SolutionsScottsdale, AZThrough a combination of technology evangelization, networking, and the use of solutions selling methodology for aligning our offerings with customer needs, the Regional Manager will further Mueller Water Products as the leading provider of solutions for aging water infrastructure and non-revenue water problems. Reporting to the Intelligent Network Sales Director, the successful candidate will be trained to uncover and nurture sales opportunities, and work with channel partners including distributors, manufacturer's representatives, value-added re-sellers, and other Mueller sales teammates to close sales.
Utilization Management Coordinator - PRN University Health Services IncUtilization Management Coordinator - PRNPhoenix, AZJob Summary: The UM Coordinator contacts external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient's stay, and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning. UHS is recognized as one of the World's Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America's Top 500 Public Companies.
NewDirector, Product Management - Salesforce EPC Eneric PetroleumDirector, Product Management - SalesforcePhoenix, ArizonaThis role owns the vision, strategy, roadmap, backlog priorities, adoption approach, and measurable outcomes for enterprise Salesforce capabilities that improve how work moves through the organization, how cases are captured and resolved, and how artificial intelligence is applied to reduce friction, improve productivity, and create better experiences. This role defines and achieves measurable OKRs, adoption, and value realization; creates strategy and roadmap; governs priorities and trade-offs; aligns stakeholders and delivery teams; and provides leadership for Salesforce Product Owners.
NewSenior Consultant, Third Party Risk Management Northern Trust CorpSenior Consultant, Third Party Risk ManagementTempe, AZ$95,600–$162,400 / yearAs a global leader in innovative wealth management, asset servicing, asset management and banking services, Northern Trust (Nasdaq: NTRS) is proud to guide the world's most successful individuals, families, corporations and institutions. Skills/Knowledge: Strong consultative skills ranging from structured problem solving, identifying and gathering relevant data, solution and business case development, influencing and communicating the risk posture of third parties.
Account Management Associate, C&F Stop Loss - Hybrid Crum & ForsterAccount Management Associate, C&F Stop Loss - HybridPhoenix, ArizonaWith our employee-first focus, the Company is consistently recognized as a great place to work, earning multiple workplace and wellness awards, including the Great Place to Work® Award, Fortune 100 Best Companies to Work For, Fortune Best Workplaces for Parents, Fortune Best Workplaces for Millennials, and many others. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions.
Account Management Associate, C&F Stop Loss Hybrid Crum & Forster Holdings Corp.Account Management Associate, C&F Stop Loss HybridScottsdale, AZWith our employee-first focus, the Company is consistently recognized as a great place to work, earning multiple workplace and wellness awards, including the Great Place to Work Award, Fortune 100 Best Companies to Work For, Fortune Best Workplaces for Parents, Fortune Best Workplaces for Millennials, and many others. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions.
NewCare Management - Nurse, Senior Blue Cross and Blue Shield AssociationCare Management - Nurse, SeniorAZIn this role you will determine, develop and implement the plan of care based on accurate assessment of the member and current or proposed treatment plan in cases of member inquiry, triage hub, chronic conditions, poly-pharmacy, pre-natal care, and voluntary member health assessment, in addition to indication of multiple monthly ER visits. Recognize the clients right to self-determination as it relates to the ethical principle of autonomy, including the client/family''s right to make informed choices that may not promote the best outcomes, as determined by the healthcare team.
Manager, Utilization Management TriWest Healthcare AllianceManager, Utilization ManagementPhoenix, AZRemoteFull timeTechnical Skills: Thorough knowledge of health care delivery, clinical quality assurance program metrics, UM, CM,CC, managed care concepts, management reporting tools, and medical management systems; ability to perform critical, in-depth analysis of medical records for appropriateness and level-of-care determinations. Manages prospective and concurrent Utilization Management (UM) programs including prior authorization, concurrent inpatient and continued stay reviews including authorization and management of selected post inpatient care.
NewCare Management Associate CVS Health CorpCare Management AssociateAZ$18.50–$35.29 / hourProvides support services to team members by answering telephone calls from providers and members, taking accurate messages, supporting electronic transmission review and referrals as appropriate, utilizes internal tools to determine required steps to ensure proper review based on clinical requirements as well as established plan guidelines. Additional responsibilities include but not limited to the following: Evaluates patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff, and coordinate the required services by the benefit plan.
NewUtilization Management Medical Director - Medical Oncology - Remote Anywhere In US UnitedHealth Group Inc.Utilization Management Medical Director - Medical Oncology - Remote Anywhere In USPhoenix, AZRemote$248,500–$373,000 / yearServe as a subject matter expert in evidence - based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidence. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role.
Medical Director Oncology - Utilization Management - Remote Anywhere In US UnitedHealth Group Inc.Medical Director Oncology - Utilization Management - Remote Anywhere In USPhoenix, AZRemote$238,000–$357,500 / yearServe as a subject matter expert in evidence - based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidence. Engage and collaborate with treating providers telephonically; This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense.
Social Worker II (ICWA) Salt River Pima-Maricopa Indian CommunitySocial Worker II (ICWA)Scottsdale, AZ$65,225–$88,057 / yearIn order to obtain preference, the following is required:1) Qualified Community Member Veteran (DD-214) will be required at the time of application submission 2) Qualified Community Member (must provide Tribal I.D at time of application submission),3) Spouse of a Community Member (Marriage License/certificate and spouse Tribal ID or CIB is required at time of application submission), and 4) Native American (Tribal ID or CIB required at time of application submission). Distinguishing Features: The Social Worker II (Case Management) is distinguished from the Social Worker I (Case Management) job class by carrying a heavier caseload and a higher proportion of difficult or complex cases.
RN Care Manager - Phoenix Market (Peoria/North Mnt) ArchWell HealthRN Care Manager - Phoenix Market (Peoria/North Mnt)Phoenix, AZJob Summary:The Nurse Care Manager is responsible for helping coordinate and evaluate the management of patients with acute and chronic conditions, across the care continuum, to achieve high quality care measured by positive patient outcomes. In our medical clinics, we provide comprehensive primary care for senior adults with traditional Medicare and Medicare Advantage plans, focused on delivering improved quality, better patient experience and lower total cost of care.
RN Care Manager - Phoenix Market ArchWell Health LLCRN Care Manager - Phoenix MarketPhoenix, AZJob Summary: The Nurse Care Manager is responsible for helping coordinate and evaluate the management of patients with acute and chronic conditions, across the care continuum, to achieve high quality care measured by positive patient outcomes. In our medical clinics, we provide comprehensive primary care for senior adults with traditional Medicare and Medicare Advantage plans, focused on delivering improved quality, better patient experience and lower total cost of care.