NewRegistered Nurses Needed! Aveanna HealthcareRegistered Nurses Needed!Phoenix, AZRemote$30–$40 / hourSee Aveanna Healthcare Terms & Conditions at https://www.aveanna.com/privacypolicy.html and Privacy Policy at https://www.aveanna.com/privacypolicy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.
Remote Healthcare Recruiter (General Healthcare - Nationwide) Gotham Enterprises LtdRemote Healthcare Recruiter (General Healthcare - Nationwide)Phoenix, AZRemote$70,000–$80,000In this role, you will be a high-volume "talent hunter," identifying and placing a diverse range of medical professionals—from Mental Health Counselors, to Registered Nurses and Physicians to Allied Health and specialized clinical staff—into top-tier healthcare facilities coast-to-coast. High-Impact Outreach: Drive candidate engagement through massive "text blast" campaigns and high-volume daily call targets (50–100 calls) to build a robust talent pipeline.
RN Case Manager- Phoenix, AZ- Hybrid Remote DaVita IncRN Case Manager- Phoenix, AZ- Hybrid RemotePhoenix, AZRemote$68,400–$100,400 / yearOur more than 600 dedicated nurses, care coordinators, nurse practitioners (NPs) and business professionals integrate and manage care for more than 20,000 patients with late-stage chronic kidney disease (CKD) and end stage renal disease (ESRD) across the US each month. DaVita Integrated Kidney Care (DaVita IKC) is an the integrated care division of DaVita Inc. working on DaVita's vision to provide integrated care to all ESRD patients, who are some of the most medically complex and vulnerable patient populations in the US.
Hybrid-Remote Medical Scribe (AZ Residents Only) CVS Health CorpHybrid-Remote Medical Scribe (AZ Residents Only)Glendale, AZRemote$17–$28.46 / hourScribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
Medical Scribe (Hybrid/remote AZ Residents Only) CVS Health CorpMedical Scribe (Hybrid/remote AZ Residents Only)Sun City, AZRemote$17–$28.46 / hourScribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
NewQuality Assurance Analyst III- Hybrid Blue Cross Blue Shield of ArizonaQuality Assurance Analyst III- HybridPhoenix, ArizonaRemoteAZ 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. 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.
Agile Product Owner II (EDI 27X) - Hybrid Blue Cross Blue Shield of ArizonaAgile Product Owner II (EDI 27X) - HybridPhoenix, ArizonaRemoteAZ 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. 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.
Healthcare Cost Reporting/Reimbursement Manager - Remote Eligible Eide Bailly LLPHealthcare Cost Reporting/Reimbursement Manager - Remote EligiblePhoenix, AZRemote$95,000–$135,000 / yearLocation: Any state with an Eide Bailly office Work Arrangement: In-office, hybrid, or remote with the ability to come into an Eide Bailly office as needed Typical Day in the Life In this role, you will lead healthcare financial projects, including Medicare and Medicaid cost report services for a variety of healthcare facilities, while also supporting other reimbursement initiatives as needed. A typical day as a Healthcare Reimbursement Manager might include the following: Overseeing cost report preparation and reimbursement engagements to ensure objectives are met, including supporting staff development, addressing client needs, and maintaining engagement profitability.
NewQuality Assurance Analyst III- Hybrid Blue Cross and Blue Shield AssociationQuality Assurance Analyst III- HybridPhoenix, AZRemoteAZ 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. 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.
Senior Product Manager (Hybrid) Experian Information Solutions IncSenior Product Manager (Hybrid)Scottsdale, AZRemoteProduct Manager for Credit, Fraud and Identity, you will own the strategic vision, discovery process, roadmap definition, and end-to-end delivery of AI-powered agents and case management workflows across our Phoenix-based squad and global co-development partners. You will translate complex credit and fraud operations needs into AI-native, scalable experiences that improve analyst speed, decision accuracy, and auditability - starting from an MVP and evolving with real operational feedback.
Agile Product Owner II (EDI 27X) - Hybrid Blue Cross and Blue Shield AssociationAgile Product Owner II (EDI 27X) - HybridPhoenix, AZRemoteAZ 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. 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.
NewHybrid Remote BCBA (Board Certified Behavior Analyst) Center for Social Dynamics IncHybrid Remote BCBA (Board Certified Behavior Analyst)Phoenix, AZRemote$85,000–$100,000 / yearWe've rebalanced service minimums to deliver greater flexibility, sustainable workloads, and real ownership over earning potential, while launching breakthrough clinical programs that strengthen outcomes for both families and clinicians. Stability & Innovation - Our model balances long‑term stability with thoughtful innovation, supporting clinicians with sustainable growth and evolving modalities that enhance clinical care - not disrupt it.
Utilization Management Registered Nurse Humana IncUtilization Management Registered NurseAZRemote$71,100–$97,800 / yearWork-at-Home Information: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
NewRegistered Nurse-Initial Clinical Reviewer (prior UM Health Plan experience)- Remote Blue Cross and Blue Shield AssociationRegistered Nurse-Initial Clinical Reviewer (prior UM Health Plan experience)- RemotePhoenix, AZRemoteWhile 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. Required Certifications N/A PREFERRED QUALIFICATIONS Preferred Work Experience 3 years of experience in clinical field of practice, health insurance, or other health care related field Preferred Education Bachelor''s Degree in Nursing or related field of study Preferred Licenses Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) as a Registered Nurse Preferred Certifications N/A ESSENTIAL job functions AND RESPONSIBILITIES Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person.
Medical Appeals and Grievance (MAG) Registered Nurse Specialist II Blue Cross Blue Shield of ArizonaMedical Appeals and Grievance (MAG) Registered Nurse Specialist IIPhoenix, ArizonaRemoteDemonstrate ability to acquire specialized knowledge to complete all types of level one appeals, grievances and corrected claims for local lines of business using appropriate benefit plan booklet, administrative guidelines and policies, medical criteria guidelines, claims research, provider contracts and fee schedules, communication records research and precertification research. Ability to demonstrate specialized knowledge to administer Federal Employee Program (FEP)inquiries, appeals, grievances and sub-reconsiderations using appropriate service benefit plan provisions, and internal policies, medical criteria guidelines, claims research, provider contracts and fee schedules, communication records research, and precertification research.
NewIntegrated Care Manager - Medicare Advantage (prior CM experience working in a health plan)- Remote Blue Cross and Blue Shield AssociationIntegrated Care Manager - Medicare Advantage (prior CM experience working in a health plan)- RemotePhoenix, AZRemoteWithin 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC). Active and current certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC).
RN Med Policy Development/Research Specialist (UM experience) - REMOTE-AZ Blue Cross Blue Shield of ArizonaRN Med Policy Development/Research Specialist (UM experience) - REMOTE-AZPhoenix, ArizonaRemoteWorking independently, initiate research from resource materials, e.g., clinical journals, periodicals, CMS (Medicare) guidelines and publications, BCBSA publications, other BCBS plans, and internet resources relating to technical, clinical and coverage guidelines, summarizing and reporting this information to management for further action. 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.
NewIntegrated Care Manager - Medicare Advantage (prior CM experience working in a health plan) Blue Cross Blue Shield of ArizonaIntegrated Care Manager - Medicare Advantage (prior CM experience working in a health plan)Phoenix, ArizonaRemoteWithin 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC). Preferred CertificationsActive and current certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC).
Remote Hospice Triage RN PT 3p-12a + rotating Sat & Sun 7:30a-4p CST IntellaTriageRemote Hospice Triage RN PT 3p-12a + rotating Sat & Sun 7:30a-4p CSTPhoenix, AZRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN PT 3p-12a + rotating Sat & Sun 7:30a-4p CST IntellaTriage, Inc.Remote Hospice Triage RN PT 3p-12a + rotating Sat & Sun 7:30a-4p CSTPhoenix, AZRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN PT 3:30p-11p Compact & CA license needed IntellaTriageRemote Hospice Triage RN PT 3:30p-11p Compact & CA license neededPhoenix, AZRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN PT Monday-Friday 1:30p-7p (No Wknds) IntellaTriageRemote Hospice Triage RN PT Monday-Friday 1:30p-7p (No Wknds)Phoenix, AZRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN PT 3:30p-11p Compact & CA license needed IntellaTriage, Inc.Remote Hospice Triage RN PT 3:30p-11p Compact & CA license neededPhoenix, AZRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN PT Monday-Friday 1:30p-7p (No Wknds) IntellaTriage, Inc.Remote Hospice Triage RN PT Monday-Friday 1:30p-7p (No Wknds)Phoenix, AZRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Registered Nurse RN RylemRemote Registered Nurse RNPhoenix, AZRemote$25–$28 / hourFull timePart timeWe’re looking for an experienced Registered Nurse Clinical Documentation Specialist to join a high-performing healthcare team in a fully remote role! If you have a strong CDI background and acute care experience, this is your chance to work from home while earning competitive travel pay.
NewSenior Network Performance Professional Humana IncSenior Network Performance ProfessionalAZRemote$78,400–$107,800 / yearWork at Home Requirements To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Area Business Manager, Rare Hematology, Phoenix, AZ SanofiArea Business Manager, Rare Hematology, Phoenix, AZPhoenix, AZRemote$125,250–$180,916.66 / yearUnderstands and applies knowledge of health care industry, trends, applicable laws and regulations, market conditions, and the market access environment (including but not limited to pharmacy-economics, payer/ reimbursement landscape and patient flow/influence between institutions and community practices) and analyze these factors in the development of business plans and in daily execution of sales calls within compliance guidelines. Main Responsibilities: Ensure effective execution of Sanofi Specialty Care (Rare Blood Disorders) strategies and tactics within assigned geographic area by developing effective business plans to execute selling strategies that are consistent with corporate brand and marketing plans and are tailored to geography and customer context.
Remote- Grievance and Appeals Nurse Pride GlobalRemote- Grievance and Appeals NursePhoenix, AZRemote$40–$45 / hourMaintains a thorough understanding of Health Plan operations and business unit processes, workflows, and system requirements, including plan benefits outlined in EOC documents, authorizations, referrals, network and non-network provider claims, and regulatory compliance. Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.
Associate Faculty - PMHNP Psychiatric Management of Children and Adolescents Graduate - Part Time (Virtual) University of Phoenix IncAssociate Faculty - PMHNP Psychiatric Management of Children and Adolescents Graduate - Part Time (Virtual)Phoenix, AZRemote$1,035–$3,686Perform a variety of additional duties, such as coaching, tutoring, and identifying appropriate additional resources, as determined by specific course and or program requirements that support student learning and success inside and outside of the classroom environment; oversee student clinical/practicum/mentorship experiences as required by the course and/or program, as applicable. Provide each student the opportunity to grow, develop, and achieve academic success by maintaining an engaged classroom presence, timely responding to student inquiries, and creating a supportive learning environment that empowers students to develop cognitive skills and confidence.
Associate Faculty - PMHNP Psychotherapy Graduate - Part-Time Faculty (Virtual) University of Phoenix IncAssociate Faculty - PMHNP Psychotherapy Graduate - Part-Time Faculty (Virtual)Phoenix, AZRemote$1,035–$3,686Perform a variety of additional duties, such as coaching, tutoring, and identifying appropriate additional resources, as determined by specific course and or program requirements that support student learning and success inside and outside of the classroom environment; oversee student clinical/practicum/mentorship experiences as required by the course and/or program, as applicable. Provide each student the opportunity to grow, develop, and achieve academic success by maintaining an engaged classroom presence, timely responding to student inquiries, and creating a supportive learning environment that empowers students to develop cognitive skills and confidence.
NewHigh-Cost Claimant Review Unit Nurse Auditor (Remote in AZ) Blue Cross Blue Shield of ArizonaHigh-Cost Claimant Review Unit Nurse Auditor (Remote in AZ)Phoenix, ArizonaRemotePrimary responsibilities include: Function as a designated clinical resource to review High Cost Claimants to identify opportunities to improve member outcomes and determine correct utilization of resources. 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.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Phoenix, AZRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
NewRemote Registered Nurse (RN) Case Manager ValerisRemote Registered Nurse (RN) Case ManagerPhoenix, ArizonaRemoteBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. calling and working with the patient’s insurance payer to determine coverage benefits, anticipated out-of-pocket costs associated with their therapy and resources for financial assistance, where applicable based upon needs communicated by the patient.
Director, Medical Document Optimization TriWest Healthcare AllianceDirector, Medical Document OptimizationPhoenix, AZRemoteFull timeLeadership: Ability to set strategic direction and translate organizational goals into operational plans; successfully leads and develops staff across varying styles and levels; provides clear expectations, effective coaching, and timely feedback; leads through a subordinate manager and drives accountability at all levels of the department. Problem Solving / Analysis: Ability to solve complex operational and systems-related problems through systematic analysis of data, workflows, and processes; exercises sound judgment in ambiguous or high-stakes situations; identifies root causes and implements durable solutions with a realistic understanding of organizational constraints.
Medical Appeals and Grievance (MAG) Specialist II - Remote Blue Cross and Blue Shield AssociationMedical Appeals and Grievance (MAG) Specialist II - RemotePhoenix, AZRemoteDemonstrate ability to acquire specialized knowledge to complete all types of level one appeals, grievances and corrected claims for local lines of business using appropriate benefit plan booklet, administrative guidelines and policies, medical criteria guidelines, claims research, provider contracts and fee schedules, communication records research and precertification research. Ability to demonstrate specialized knowledge to administer Federal Employee Program (FEP)inquiries, appeals, grievances and sub-reconsiderations using appropriate service benefit plan provisions, and internal policies, medical criteria guidelines, claims research, provider contracts and fee schedules, communication records research, and precertification research.
Remote- Grievance and Appeals Nurse Pride Technologies LLCRemote- Grievance and Appeals NursePhoenix, AZRemote$40–$45 / hourMaintains a thorough understanding of Health Plan operations and business unit processes, workflows, and system requirements, including plan benefits outlined in EOC documents, authorizations, referrals, network and non-network provider claims, and regulatory compliance. Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.
Utilization Management Nurse Consultant (Weekend) CVS Health CorpUtilization Management Nurse Consultant (Weekend)AZRemote$29.10–$62.32 / hourEducation: Diploma RN acceptable; Associate degree/BSN preferred, 3+ years of experience as a Registered Nurse, 1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience. Position Summary: Utilize your clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members.
REMOTE RN - Quality Review Teema GroupREMOTE RN - Quality ReviewPhoenix, AZRemote$42–$43.50This role focuses on reviewing clinical cases, identifying potential quality or safety concerns, and supporting quality improvement initiatives across a complex healthcare delivery network. This is an excellent opportunity for a licensed clinical professional with experience in clinical review, utilization management, or healthcare quality within health plans, hospital systems, or government-supported programs.
Medical Appeals and Grievance (MAG) Specialist II Blue Cross Blue Shield of ArizonaMedical Appeals and Grievance (MAG) Specialist IIPhoenix, ArizonaRemoteDemonstrate ability to acquire specialized knowledge to complete all types of level one appeals, grievances and corrected claims for local lines of business using appropriate benefit plan booklet, administrative guidelines and policies, medical criteria guidelines, claims research, provider contracts and fee schedules, communication records research and precertification research. Ability to demonstrate specialized knowledge to administer Federal Employee Program (FEP)inquiries, appeals, grievances and sub-reconsiderations using appropriate service benefit plan provisions, and internal policies, medical criteria guidelines, claims research, provider contracts and fee schedules, communication records research, and precertification research.
Quality Assurance Nursing Consultant Arizona Department of AdministrationQuality Assurance Nursing ConsultantPhoenix, ArizonaRemoteProvide education and technical assistance to internal and external stakeholders, as appropriate, regarding covered services, and contractual or policy requirements, accurately and consistently to improve compliance with AHCCCS requirements and improve quality of care and service to AHCCCS members. This position will complete comprehensive assessments of available resources on service providers and individual members; review case material to ensure compliance with State and Federal regulations and policies; and provide timely resolution of multiple cases assigned.
NewOncology Nurse Navigator Onco360Oncology Nurse NavigatorScottsdale, ArizonaRemoteOnco360 is a unique Oncology Pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Oncology Nurse Navigator Position Responsibilities:Communicate with patients helping them understand the disease, treatment plan and possible side effects.
Medical & Disability Nurse Case Manager Liberty Mutual Holding Company IncMedical & Disability Nurse Case ManagerChandler, AZRemoteEffectively communicates with injured employees, medical professionals, field claims staff, attorneys, and others to obtain information, and to negotiate medical treatment and return to work plans using critical thinking skills, clinical expertise and other resources as needed to achieve an optimal case outcome. Under general technical direction, responsible for medically managing assigned caseload and by applying clinical expertise ensure individuals receive appropriate healthcare in order to return to work and normal activity in a timely and cost effective manner.
Sr. Compliance Specialist - Care Management Programs ValenzSr. Compliance Specialist - Care Management ProgramsPhoenix, AZRemoteFull timeOversee and support the organization’s multi-state Utilization Management licensing program by tracking licensing requirements across applicable jurisdictions, coordinating license applications and renewals, maintaining supporting documentation, and partnering with operational leaders to ensure ongoing compliance with licensing conditions and regulatory obligations. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification.
Care Manager (RN) Remote (Must reside in Arizona) Molina Healthcare IncCare Manager (RN) Remote (Must reside in Arizona)Phoenix, AZRemoteCompletes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
Business Intelligence Developer-Medicaid - Level I (Remote AZ) Blue Cross and Blue Shield AssociationBusiness Intelligence Developer-Medicaid - Level I (Remote AZ)Phoenix, AZRemoteThis position partners with business leaders across the organization to provide high quality reporting and analysis that is accurate, thoroughly researched, assists in identifying risks & opportunities, and provides untapped insights and knowledge to enable data driven and data literate decision making for departments and teams throughout the entire Medicaid segment. The Business Intelligence Developer - Medicaid role is responsible for the design, creation, and maintenance of sustainable reporting solutions and analytical insights that improve efficiency, drive innovation, and inform data driven decision making in support of broader business and corporate strategies across the organization.
Business Intelligence Developer-Medicaid - Level I (Remote AZ) Blue Cross Blue Shield of ArizonaBusiness Intelligence Developer-Medicaid - Level I (Remote AZ)Phoenix, ArizonaRemoteThis position partners with business leaders across the organization to provide high quality reporting and analysis that is accurate, thoroughly researched, assists in identifying risks & opportunities, and provides untapped insights and knowledge to enable data driven and data literate decision making for departments and teams throughout the entire Medicaid segment. The Business Intelligence Developer - Medicaid role is responsible for the design, creation, and maintenance of sustainable reporting solutions and analytical insights that improve efficiency, drive innovation, and inform data driven decision making in support of broader business and corporate strategies across the organization.
Quality Assurance Nursing Consultant State of ArizonaQuality Assurance Nursing ConsultantPhoenix, AZRemoteProvide education and technical assistance to internal and external stakeholders, as appropriate, regarding covered services, and contractual or policy requirements, accurately and consistently to improve compliance with AHCCCS requirements and improve quality of care and service to AHCCCS members. This position will complete comprehensive assessments of available resources on service providers and individual members; review case material to ensure compliance with State and Federal regulations and policies; and provide timely resolution of multiple cases assigned.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorGlendale, AZRemote$72,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
NewRN Quality Measure Specialist Banner HealthRN Quality Measure SpecialistPhoenix, AZRemote$35.43–$59.05 / hourThis fully remote role focuses on validation, abstraction, and submission of clinical quality measures, including MIPS (CQMs, Eligible Clinician and Eligible Hospital eCQMs), Core Measures, and The Joint Commission requirements. This position performs clinical data abstraction and/or validation activities in support of regulatory programs and associated clinical quality measures, including IQR, OQR, IPFQR, Core Measures, TJC, and MIPS (CQM & eCQM).
Care Management Nursing Consultant Arizona Department of AdministrationCare Management Nursing ConsultantPhoenix, ArizonaRemoteProvide education and technical assistance to internal and external stakeholders as appropriate, regarding covered services, and contractual or policy requirements, accurately and consistently to improve compliance with AHCCCS requirements and improve quality of care and service to AHCCCS members. • Monitor compliance with State and Federal regulations, tracking, and trending case management data to include escalation of and action taken by case management team in response to COOP initiation, quality of care concerns and/or health and safety/immediate jeopardy concerns.