Registered Nurse - Medical Policy Development/Research Specialist - Remote - AZ Blue Cross and Blue Shield AssociationRegistered Nurse - Medical Policy Development/Research Specialist - Remote - AZPhoenix, AZRemoteWorking 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.
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.
Utilization Management Registered Nurse Humana IncUtilization Management Registered NurseAZRemote$71,100–$97,800 / yearp>Work-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.
Case Manager Registered Nurse (Remote) CVS Health CorpCase Manager Registered Nurse (Remote)AZRemote$60,522–$129,615 / yearul>Assessing the member's health status and care coordination needs, inpatient review and discharge planning, developing and implementing the CM plan, monitoring and evaluating the plan and involving the Medical Director as indicated and closing the case as appropriate when the member has met discharge criteria. The Care Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Case Manager, Registered Nurse - Fully Remote CVS Health CorpCase Manager, Registered Nurse - Fully RemoteAZRemote$54,095–$155,538 / yearBenefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
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, AZRemoteem>Read more about being a nurse at IntellaTriage, and the reward: https://intellatriage.com/telehealth-solutions-media/2024-nurse-of-the-year/. Utilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care.
Virtual Healthcare Manager (Remote) Imagine LearningVirtual Healthcare Manager (Remote)Tempe, AZRemotep>The Patient Care Manager will lead care coordination efforts, support patient engagement, and ensure the delivery of high-quality, patient-centered services across virtual care platforms. This role serves as a key liaison between patients, healthcare providers, and internal teams, ensuring seamless communication and effective care management.
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, AZRemoteRead more about being a nurse at IntellaTriage, and the reward: https://intellatriage.com/telehealth-solutions-media/2024-nurse-of-the-year/. Utilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care.
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.
Remote Hospice Triage RN PT 3:30p-11p Compact & CA license needed IntellaTriageRemote Hospice Triage RN PT 3:30p-11p Compact & CA license neededPhoenix, AZRemoteem>Read more about being a nurse at IntellaTriage, and the reward: https://intellatriage.com/telehealth-solutions-media/2024-nurse-of-the-year/. Utilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care.
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, AZRemoteem>Read more about being a nurse at IntellaTriage, and the reward: https://intellatriage.com/telehealth-solutions-media/2024-nurse-of-the-year/. Utilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care.
Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEPhoenix, AZRemoteli>Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years of health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
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, AZRemoteRead more about being a nurse at IntellaTriage, and the reward: https://intellatriage.com/telehealth-solutions-media/2024-nurse-of-the-year/. Utilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care.
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, AZRemoteRead more about being a nurse at IntellaTriage, and the reward: https://intellatriage.com/telehealth-solutions-media/2024-nurse-of-the-year/. Utilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care.
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.
Remote- Grievance and Appeals Nurse Pride GlobalRemote- Grievance and Appeals NursePhoenix, AZRemote$40–$45 / hourli>Maintains 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.
Integrated Care Manager - Remote Blue Cross and Blue Shield AssociationIntegrated Care Manager - RemotePhoenix, AZRemoteul>Within 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, ArizonaRemoteli>Working 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.
Remote- Grievance and Appeals Nurse Pride Technologies LLCRemote- Grievance and Appeals NursePhoenix, AZRemote$40–$45 / hourli>Maintains 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.
Remote RN | California License Required Pine Park HealthRemote RN | California License RequiredPhoenix, AZRemoteh3>Why You'll Love Us: We're a smart, heart-centered, low-ego group motivated to make waves in the lives of seniors and the healthcare industry. This job description in no way states or implies that these are the only duties to which will be required in this position, employees may be required to follow other job-related duties as requested by their supervisor/manager (within guidelines and compliance with Federal and State Laws).
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.
Clinical Quality Coordinator QOC RN - Remote Blue Cross and Blue Shield AssociationClinical Quality Coordinator QOC RN - RemotePhoenix, AZRemoteStrong verbal and written communication skills and the ability to compose a variety of business correspondence and interact professionally with a diverse groups, executives, managers, and subject matter experts. 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.
Senior Clinical Admin Nurse RN - Remote UnitedHealth Group IncSenior Clinical Admin Nurse RN - RemoteChandler, AZRemote$60,200–$107,400 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Willing and able to work with an interdisciplinary team of professionals including pharmacists and technicians, physicians and other licensed prescribers, registered dietitians, home health agencies (HHAs), sales representatives, and others as needed to provide comprehensive care and support of patients and caregivers.
Medical Appeals and Grievance (MAG) Registered Nurse Specialist II Blue Cross Blue Shield of ArizonaMedical Appeals and Grievance (MAG) Registered Nurse Specialist IIPhoenix, ArizonaRemoteli>Demonstrate 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.
Licensed Clinical Social Worker- Remote BetterHelpLicensed Clinical Social Worker- RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Licensed Marriage and Family Therapist - Remote BetterHelpLicensed Marriage and Family Therapist - RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Licensed Psychologist- Remote BetterHelpLicensed Psychologist- RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Licensed Professional Counselor - Remote BetterHelpLicensed Professional Counselor - RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Medical Appeals and Grievance (MAG) Specialist II - Remote Blue Cross and Blue Shield AssociationMedical Appeals and Grievance (MAG) Specialist II - RemotePhoenix, AZRemoteli>Demonstrate 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.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.RN Medical Management Services Banner HealthRN Medical Management ServicesScottsdale, AZRemote$35.43–$59.05 / hourBanner Plans & Networks (BPN) is an accountable care organization that joins Arizona''s largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. This position is responsible to process health plan medical pre-service requests, provide case management, care coordination and perform utilization management duties within the appropriate time period as outlined in the Medical Management Program Descriptions, and in accordance with all federal and state regulations.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.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.Care Manager, Telephonic Nurse 2 Humana IncCare Manager, Telephonic Nurse 2AZRemote$71,100–$97,800 / yearAs the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. In this pivotal role, you will support our Patient Management Program, focusing on individuals with specialized and complex health conditions, including autoimmune disorders, pulmonary diseases, neuromuscular disorders, infectious diseases, cancers, and other rare conditions.Integrated Care Manager Blue Cross Blue Shield of ArizonaIntegrated Care ManagerPhoenix, ArizonaRemoteul>Within 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).Sr. Compliance Specialist - Care Management Programs ValenzSr. Compliance Specialist - Care Management ProgramsPhoenix, AZRemoteFull timeBilingual (Spanish) Advanced Practice Provider (NP or PA): Cardiology Devoted Health IncBilingual (Spanish) Advanced Practice Provider (NP or PA): CardiologyAZRemoteAs part of the clinic you will also provide dedicated clinical services during part of your clinical time to our heart failure clinic which is a highly tailored, specialty center focused on providing best in class heart failure management including optimizing guideline directed medical therapy, providing health coaching, and managing volume overload. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.Bilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA) Devoted Health IncBilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA)Fully Remote, AZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerPhoenix, AZRemoteFull timeo Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.Clinical Quality Study Analyst TriWest Healthcare AllianceClinical Quality Study AnalystPhoenix, AZRemoteFull timeTechnical Skills: General knowledge of Medicare, Veteran's Administration, TRICARE, or other government health care programs; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.Clinical Quality Review Team Lead TriWest Healthcare AllianceClinical Quality Review Team LeadPhoenix, AZRemoteFull timeThe team lead supports clinical and non-clinical staff supporting CQM programs by providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.Clinical Education Training Specialist TriWest Healthcare AllianceClinical Education Training SpecialistPhoenix, AZRemoteFull timeAssist with training department-specific needs, such as, maintaining required training documentation, maintaining both clinical and non-clinical training and orientation curriculum, participating in clinical operations leadership meetings, process improvement meetings, and other duties as appropriate and requested. In addition, this position requires designing, developing and presenting synchronous training courses relating to clinical and operational topics, and includes content, visual aides, exercises for the student and examinations.Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP) Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.NewBilingual (Spanish/English) Transitions of Care Advanced Practice Provider Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.NewTransitions of Care Advanced Practice Provider Devoted Health IncTransitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.Transitions of Care Advanced Practice Provider (APP) Devoted Health IncTransitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.Speech Language Pathologist (SLP) - Teletherapy The Stepping Stones Group LLCSpeech Language Pathologist (SLP) - TeletherapyAZRemoteNew Jersey Asbury Park Atlantic City Barnegat Basking Ridge Bayonne BELLMAWR Bergenfield Berkeley Heights Blackwood Brick Bridgeton Bridgewater Butler Camden Cape May Court House Central Region Cherry HIll Chester Clementon Clifton Cranford Cresskill Deptford Dumont Dunellen East Brunswick East Orange Edgewater Park Edison Egg Harbor Township Elizabeth Englishtown Ewing Fair Lawn Flemington Franklin Lakes Freehold Garfield Gibbstown Gillette Hackensack Haddon Field Hainesport Hamilton Hammonton Hasbrouck Heights Haworth Hillsborough Holmdel Jamesburg Jersey City Lakewood Leonardo Lindenwold Little Egg Harbor Livingston Lodi Manalapan Manville Marlton Matawan Millington Millville Monmouth Monmouth Junction Monroe Township Montague Montclair Montville Morganville Mount Holly New Brunswick New Providence North Bergen Northfield Nutley Ocean Gate Oradell Parlin Parsippany Passaic Penns Grove Pennsauken Pequannock Perth Amboy Piscataway Pleasantville Point Pleasant Beach Pompton Plains Red Bank Ridgewood Rosenhayn Scotch Plains Skillman South Bound Brook South Orange Tenafly Tenefly Tinton Falls Toms River Tuckerton Union Vernon Verona Waldwick Wanamassa Watchung Wayne West Long Branch West New York Westampton Williamstown Willingboro Woodstown Wrightstown. Minnesota Aitkin Albert Lea Anoka Bemidji Bloomington Brooklyn Center Brooklyn Park Buffalo Burnsville Cedar Champlin Chaska Circle Pines Cloquet Cold Spring Columbia Heights Coon Rapids Cottage Grove Crosby East Grand Forks Eden Prairie Eden Valley Edina Elk River Faribault Forest Lake Hopkins Houston Hutchinson Inver Grove Heights Lakeville Mahtomedi Mankato Maple Grove Marine On Saint Croix Marshall Minneapolis Minnetrista Naytahwausch New Prague North Branch North St. Paul Oak Grove Onamia Osseo Princeton Prior Lake Red Wing Richfield Rochester Rollingstone Rosemount Roseville Rush City Saint Paul Sartell Sauk Centre Shakopee Shoreview South St. Paul Spring Lake Park St. Cloud St. Francis St. Louis Park St. Paul Stillwater Tofte Tower Wayzata West St. Paul White Bear Lake Willmar.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–$3,686li>Perform 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 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–$3,686li>Perform 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.Health Assistant - North Phoenix Great HeartsHealth Assistant - North PhoenixPhoenix, AZRemote$18–$25 / hourCompany Description Great Hearts Academies is a growing network of 45 public, open-enrollment, tuition-free schools in Arizona, Texas, and Louisiana. The school health assistants, as delegated by the Registered Nurse, are responsible for taking care of students and ensuring their good health and safety while on school premises.Load moreResume ResourcesFree Resume TemplatesFree Resume Builder
Licensed Marriage and Family Therapist - Remote BetterHelpLicensed Marriage and Family Therapist - RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Licensed Psychologist- Remote BetterHelpLicensed Psychologist- RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Licensed Professional Counselor - Remote BetterHelpLicensed Professional Counselor - RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Medical Appeals and Grievance (MAG) Specialist II - Remote Blue Cross and Blue Shield AssociationMedical Appeals and Grievance (MAG) Specialist II - RemotePhoenix, AZRemoteli>Demonstrate 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.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.RN Medical Management Services Banner HealthRN Medical Management ServicesScottsdale, AZRemote$35.43–$59.05 / hourBanner Plans & Networks (BPN) is an accountable care organization that joins Arizona''s largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. This position is responsible to process health plan medical pre-service requests, provide case management, care coordination and perform utilization management duties within the appropriate time period as outlined in the Medical Management Program Descriptions, and in accordance with all federal and state regulations.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.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.Care Manager, Telephonic Nurse 2 Humana IncCare Manager, Telephonic Nurse 2AZRemote$71,100–$97,800 / yearAs the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. In this pivotal role, you will support our Patient Management Program, focusing on individuals with specialized and complex health conditions, including autoimmune disorders, pulmonary diseases, neuromuscular disorders, infectious diseases, cancers, and other rare conditions.Integrated Care Manager Blue Cross Blue Shield of ArizonaIntegrated Care ManagerPhoenix, ArizonaRemoteul>Within 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).Sr. Compliance Specialist - Care Management Programs ValenzSr. Compliance Specialist - Care Management ProgramsPhoenix, AZRemoteFull timeBilingual (Spanish) Advanced Practice Provider (NP or PA): Cardiology Devoted Health IncBilingual (Spanish) Advanced Practice Provider (NP or PA): CardiologyAZRemoteAs part of the clinic you will also provide dedicated clinical services during part of your clinical time to our heart failure clinic which is a highly tailored, specialty center focused on providing best in class heart failure management including optimizing guideline directed medical therapy, providing health coaching, and managing volume overload. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.Bilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA) Devoted Health IncBilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA)Fully Remote, AZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerPhoenix, AZRemoteFull timeo Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.Clinical Quality Study Analyst TriWest Healthcare AllianceClinical Quality Study AnalystPhoenix, AZRemoteFull timeTechnical Skills: General knowledge of Medicare, Veteran's Administration, TRICARE, or other government health care programs; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.Clinical Quality Review Team Lead TriWest Healthcare AllianceClinical Quality Review Team LeadPhoenix, AZRemoteFull timeThe team lead supports clinical and non-clinical staff supporting CQM programs by providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.Clinical Education Training Specialist TriWest Healthcare AllianceClinical Education Training SpecialistPhoenix, AZRemoteFull timeAssist with training department-specific needs, such as, maintaining required training documentation, maintaining both clinical and non-clinical training and orientation curriculum, participating in clinical operations leadership meetings, process improvement meetings, and other duties as appropriate and requested. In addition, this position requires designing, developing and presenting synchronous training courses relating to clinical and operational topics, and includes content, visual aides, exercises for the student and examinations.Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP) Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.NewBilingual (Spanish/English) Transitions of Care Advanced Practice Provider Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.NewTransitions of Care Advanced Practice Provider Devoted Health IncTransitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.Transitions of Care Advanced Practice Provider (APP) Devoted Health IncTransitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.Speech Language Pathologist (SLP) - Teletherapy The Stepping Stones Group LLCSpeech Language Pathologist (SLP) - TeletherapyAZRemoteNew Jersey Asbury Park Atlantic City Barnegat Basking Ridge Bayonne BELLMAWR Bergenfield Berkeley Heights Blackwood Brick Bridgeton Bridgewater Butler Camden Cape May Court House Central Region Cherry HIll Chester Clementon Clifton Cranford Cresskill Deptford Dumont Dunellen East Brunswick East Orange Edgewater Park Edison Egg Harbor Township Elizabeth Englishtown Ewing Fair Lawn Flemington Franklin Lakes Freehold Garfield Gibbstown Gillette Hackensack Haddon Field Hainesport Hamilton Hammonton Hasbrouck Heights Haworth Hillsborough Holmdel Jamesburg Jersey City Lakewood Leonardo Lindenwold Little Egg Harbor Livingston Lodi Manalapan Manville Marlton Matawan Millington Millville Monmouth Monmouth Junction Monroe Township Montague Montclair Montville Morganville Mount Holly New Brunswick New Providence North Bergen Northfield Nutley Ocean Gate Oradell Parlin Parsippany Passaic Penns Grove Pennsauken Pequannock Perth Amboy Piscataway Pleasantville Point Pleasant Beach Pompton Plains Red Bank Ridgewood Rosenhayn Scotch Plains Skillman South Bound Brook South Orange Tenafly Tenefly Tinton Falls Toms River Tuckerton Union Vernon Verona Waldwick Wanamassa Watchung Wayne West Long Branch West New York Westampton Williamstown Willingboro Woodstown Wrightstown. Minnesota Aitkin Albert Lea Anoka Bemidji Bloomington Brooklyn Center Brooklyn Park Buffalo Burnsville Cedar Champlin Chaska Circle Pines Cloquet Cold Spring Columbia Heights Coon Rapids Cottage Grove Crosby East Grand Forks Eden Prairie Eden Valley Edina Elk River Faribault Forest Lake Hopkins Houston Hutchinson Inver Grove Heights Lakeville Mahtomedi Mankato Maple Grove Marine On Saint Croix Marshall Minneapolis Minnetrista Naytahwausch New Prague North Branch North St. Paul Oak Grove Onamia Osseo Princeton Prior Lake Red Wing Richfield Rochester Rollingstone Rosemount Roseville Rush City Saint Paul Sartell Sauk Centre Shakopee Shoreview South St. Paul Spring Lake Park St. Cloud St. Francis St. Louis Park St. Paul Stillwater Tofte Tower Wayzata West St. Paul White Bear Lake Willmar.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–$3,686li>Perform 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 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–$3,686li>Perform 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.Health Assistant - North Phoenix Great HeartsHealth Assistant - North PhoenixPhoenix, AZRemote$18–$25 / hourCompany Description Great Hearts Academies is a growing network of 45 public, open-enrollment, tuition-free schools in Arizona, Texas, and Louisiana. The school health assistants, as delegated by the Registered Nurse, are responsible for taking care of students and ensuring their good health and safety while on school premises.Load moreResume ResourcesFree Resume TemplatesFree Resume Builder
Licensed Psychologist- Remote BetterHelpLicensed Psychologist- RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Licensed Professional Counselor - Remote BetterHelpLicensed Professional Counselor - RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Medical Appeals and Grievance (MAG) Specialist II - Remote Blue Cross and Blue Shield AssociationMedical Appeals and Grievance (MAG) Specialist II - RemotePhoenix, AZRemoteli>Demonstrate 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.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.RN Medical Management Services Banner HealthRN Medical Management ServicesScottsdale, AZRemote$35.43–$59.05 / hourBanner Plans & Networks (BPN) is an accountable care organization that joins Arizona''s largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. This position is responsible to process health plan medical pre-service requests, provide case management, care coordination and perform utilization management duties within the appropriate time period as outlined in the Medical Management Program Descriptions, and in accordance with all federal and state regulations.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.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.Care Manager, Telephonic Nurse 2 Humana IncCare Manager, Telephonic Nurse 2AZRemote$71,100–$97,800 / yearAs the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. In this pivotal role, you will support our Patient Management Program, focusing on individuals with specialized and complex health conditions, including autoimmune disorders, pulmonary diseases, neuromuscular disorders, infectious diseases, cancers, and other rare conditions.Integrated Care Manager Blue Cross Blue Shield of ArizonaIntegrated Care ManagerPhoenix, ArizonaRemoteul>Within 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).Sr. Compliance Specialist - Care Management Programs ValenzSr. Compliance Specialist - Care Management ProgramsPhoenix, AZRemoteFull timeBilingual (Spanish) Advanced Practice Provider (NP or PA): Cardiology Devoted Health IncBilingual (Spanish) Advanced Practice Provider (NP or PA): CardiologyAZRemoteAs part of the clinic you will also provide dedicated clinical services during part of your clinical time to our heart failure clinic which is a highly tailored, specialty center focused on providing best in class heart failure management including optimizing guideline directed medical therapy, providing health coaching, and managing volume overload. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.Bilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA) Devoted Health IncBilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA)Fully Remote, AZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerPhoenix, AZRemoteFull timeo Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.Clinical Quality Study Analyst TriWest Healthcare AllianceClinical Quality Study AnalystPhoenix, AZRemoteFull timeTechnical Skills: General knowledge of Medicare, Veteran's Administration, TRICARE, or other government health care programs; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.Clinical Quality Review Team Lead TriWest Healthcare AllianceClinical Quality Review Team LeadPhoenix, AZRemoteFull timeThe team lead supports clinical and non-clinical staff supporting CQM programs by providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.Clinical Education Training Specialist TriWest Healthcare AllianceClinical Education Training SpecialistPhoenix, AZRemoteFull timeAssist with training department-specific needs, such as, maintaining required training documentation, maintaining both clinical and non-clinical training and orientation curriculum, participating in clinical operations leadership meetings, process improvement meetings, and other duties as appropriate and requested. In addition, this position requires designing, developing and presenting synchronous training courses relating to clinical and operational topics, and includes content, visual aides, exercises for the student and examinations.Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP) Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.NewBilingual (Spanish/English) Transitions of Care Advanced Practice Provider Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.NewTransitions of Care Advanced Practice Provider Devoted Health IncTransitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.Transitions of Care Advanced Practice Provider (APP) Devoted Health IncTransitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.Speech Language Pathologist (SLP) - Teletherapy The Stepping Stones Group LLCSpeech Language Pathologist (SLP) - TeletherapyAZRemoteNew Jersey Asbury Park Atlantic City Barnegat Basking Ridge Bayonne BELLMAWR Bergenfield Berkeley Heights Blackwood Brick Bridgeton Bridgewater Butler Camden Cape May Court House Central Region Cherry HIll Chester Clementon Clifton Cranford Cresskill Deptford Dumont Dunellen East Brunswick East Orange Edgewater Park Edison Egg Harbor Township Elizabeth Englishtown Ewing Fair Lawn Flemington Franklin Lakes Freehold Garfield Gibbstown Gillette Hackensack Haddon Field Hainesport Hamilton Hammonton Hasbrouck Heights Haworth Hillsborough Holmdel Jamesburg Jersey City Lakewood Leonardo Lindenwold Little Egg Harbor Livingston Lodi Manalapan Manville Marlton Matawan Millington Millville Monmouth Monmouth Junction Monroe Township Montague Montclair Montville Morganville Mount Holly New Brunswick New Providence North Bergen Northfield Nutley Ocean Gate Oradell Parlin Parsippany Passaic Penns Grove Pennsauken Pequannock Perth Amboy Piscataway Pleasantville Point Pleasant Beach Pompton Plains Red Bank Ridgewood Rosenhayn Scotch Plains Skillman South Bound Brook South Orange Tenafly Tenefly Tinton Falls Toms River Tuckerton Union Vernon Verona Waldwick Wanamassa Watchung Wayne West Long Branch West New York Westampton Williamstown Willingboro Woodstown Wrightstown. Minnesota Aitkin Albert Lea Anoka Bemidji Bloomington Brooklyn Center Brooklyn Park Buffalo Burnsville Cedar Champlin Chaska Circle Pines Cloquet Cold Spring Columbia Heights Coon Rapids Cottage Grove Crosby East Grand Forks Eden Prairie Eden Valley Edina Elk River Faribault Forest Lake Hopkins Houston Hutchinson Inver Grove Heights Lakeville Mahtomedi Mankato Maple Grove Marine On Saint Croix Marshall Minneapolis Minnetrista Naytahwausch New Prague North Branch North St. Paul Oak Grove Onamia Osseo Princeton Prior Lake Red Wing Richfield Rochester Rollingstone Rosemount Roseville Rush City Saint Paul Sartell Sauk Centre Shakopee Shoreview South St. Paul Spring Lake Park St. Cloud St. Francis St. Louis Park St. Paul Stillwater Tofte Tower Wayzata West St. Paul White Bear Lake Willmar.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–$3,686li>Perform 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 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–$3,686li>Perform 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.Health Assistant - North Phoenix Great HeartsHealth Assistant - North PhoenixPhoenix, AZRemote$18–$25 / hourCompany Description Great Hearts Academies is a growing network of 45 public, open-enrollment, tuition-free schools in Arizona, Texas, and Louisiana. The school health assistants, as delegated by the Registered Nurse, are responsible for taking care of students and ensuring their good health and safety while on school premises.Load moreResume ResourcesFree Resume TemplatesFree Resume Builder
Licensed Professional Counselor - Remote BetterHelpLicensed Professional Counselor - RemotePhoenix, AZRemoteAlso, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor).Experience counseling adults, couples, and/or teens.. Private practice with no doors and no overhead..Medical Appeals and Grievance (MAG) Specialist II - Remote Blue Cross and Blue Shield AssociationMedical Appeals and Grievance (MAG) Specialist II - RemotePhoenix, AZRemoteli>Demonstrate 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.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.RN Medical Management Services Banner HealthRN Medical Management ServicesScottsdale, AZRemote$35.43–$59.05 / hourBanner Plans & Networks (BPN) is an accountable care organization that joins Arizona''s largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. This position is responsible to process health plan medical pre-service requests, provide case management, care coordination and perform utilization management duties within the appropriate time period as outlined in the Medical Management Program Descriptions, and in accordance with all federal and state regulations.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.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.Care Manager, Telephonic Nurse 2 Humana IncCare Manager, Telephonic Nurse 2AZRemote$71,100–$97,800 / yearAs the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. In this pivotal role, you will support our Patient Management Program, focusing on individuals with specialized and complex health conditions, including autoimmune disorders, pulmonary diseases, neuromuscular disorders, infectious diseases, cancers, and other rare conditions.Integrated Care Manager Blue Cross Blue Shield of ArizonaIntegrated Care ManagerPhoenix, ArizonaRemoteul>Within 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).Sr. Compliance Specialist - Care Management Programs ValenzSr. Compliance Specialist - Care Management ProgramsPhoenix, AZRemoteFull timeBilingual (Spanish) Advanced Practice Provider (NP or PA): Cardiology Devoted Health IncBilingual (Spanish) Advanced Practice Provider (NP or PA): CardiologyAZRemoteAs part of the clinic you will also provide dedicated clinical services during part of your clinical time to our heart failure clinic which is a highly tailored, specialty center focused on providing best in class heart failure management including optimizing guideline directed medical therapy, providing health coaching, and managing volume overload. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.Bilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA) Devoted Health IncBilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA)Fully Remote, AZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerPhoenix, AZRemoteFull timeo Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.Clinical Quality Study Analyst TriWest Healthcare AllianceClinical Quality Study AnalystPhoenix, AZRemoteFull timeTechnical Skills: General knowledge of Medicare, Veteran's Administration, TRICARE, or other government health care programs; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.Clinical Quality Review Team Lead TriWest Healthcare AllianceClinical Quality Review Team LeadPhoenix, AZRemoteFull timeThe team lead supports clinical and non-clinical staff supporting CQM programs by providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.Clinical Education Training Specialist TriWest Healthcare AllianceClinical Education Training SpecialistPhoenix, AZRemoteFull timeAssist with training department-specific needs, such as, maintaining required training documentation, maintaining both clinical and non-clinical training and orientation curriculum, participating in clinical operations leadership meetings, process improvement meetings, and other duties as appropriate and requested. In addition, this position requires designing, developing and presenting synchronous training courses relating to clinical and operational topics, and includes content, visual aides, exercises for the student and examinations.Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP) Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.NewBilingual (Spanish/English) Transitions of Care Advanced Practice Provider Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.NewTransitions of Care Advanced Practice Provider Devoted Health IncTransitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.Transitions of Care Advanced Practice Provider (APP) Devoted Health IncTransitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.Speech Language Pathologist (SLP) - Teletherapy The Stepping Stones Group LLCSpeech Language Pathologist (SLP) - TeletherapyAZRemoteNew Jersey Asbury Park Atlantic City Barnegat Basking Ridge Bayonne BELLMAWR Bergenfield Berkeley Heights Blackwood Brick Bridgeton Bridgewater Butler Camden Cape May Court House Central Region Cherry HIll Chester Clementon Clifton Cranford Cresskill Deptford Dumont Dunellen East Brunswick East Orange Edgewater Park Edison Egg Harbor Township Elizabeth Englishtown Ewing Fair Lawn Flemington Franklin Lakes Freehold Garfield Gibbstown Gillette Hackensack Haddon Field Hainesport Hamilton Hammonton Hasbrouck Heights Haworth Hillsborough Holmdel Jamesburg Jersey City Lakewood Leonardo Lindenwold Little Egg Harbor Livingston Lodi Manalapan Manville Marlton Matawan Millington Millville Monmouth Monmouth Junction Monroe Township Montague Montclair Montville Morganville Mount Holly New Brunswick New Providence North Bergen Northfield Nutley Ocean Gate Oradell Parlin Parsippany Passaic Penns Grove Pennsauken Pequannock Perth Amboy Piscataway Pleasantville Point Pleasant Beach Pompton Plains Red Bank Ridgewood Rosenhayn Scotch Plains Skillman South Bound Brook South Orange Tenafly Tenefly Tinton Falls Toms River Tuckerton Union Vernon Verona Waldwick Wanamassa Watchung Wayne West Long Branch West New York Westampton Williamstown Willingboro Woodstown Wrightstown. Minnesota Aitkin Albert Lea Anoka Bemidji Bloomington Brooklyn Center Brooklyn Park Buffalo Burnsville Cedar Champlin Chaska Circle Pines Cloquet Cold Spring Columbia Heights Coon Rapids Cottage Grove Crosby East Grand Forks Eden Prairie Eden Valley Edina Elk River Faribault Forest Lake Hopkins Houston Hutchinson Inver Grove Heights Lakeville Mahtomedi Mankato Maple Grove Marine On Saint Croix Marshall Minneapolis Minnetrista Naytahwausch New Prague North Branch North St. Paul Oak Grove Onamia Osseo Princeton Prior Lake Red Wing Richfield Rochester Rollingstone Rosemount Roseville Rush City Saint Paul Sartell Sauk Centre Shakopee Shoreview South St. Paul Spring Lake Park St. Cloud St. Francis St. Louis Park St. Paul Stillwater Tofte Tower Wayzata West St. Paul White Bear Lake Willmar.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–$3,686li>Perform 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 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–$3,686li>Perform 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.Health Assistant - North Phoenix Great HeartsHealth Assistant - North PhoenixPhoenix, AZRemote$18–$25 / hourCompany Description Great Hearts Academies is a growing network of 45 public, open-enrollment, tuition-free schools in Arizona, Texas, and Louisiana. The school health assistants, as delegated by the Registered Nurse, are responsible for taking care of students and ensuring their good health and safety while on school premises.Load moreResume ResourcesFree Resume TemplatesFree Resume Builder
Medical Appeals and Grievance (MAG) Specialist II - Remote Blue Cross and Blue Shield AssociationMedical Appeals and Grievance (MAG) Specialist II - RemotePhoenix, AZRemoteli>Demonstrate 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.
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.
RN Medical Management Services Banner HealthRN Medical Management ServicesScottsdale, AZRemote$35.43–$59.05 / hourBanner Plans & Networks (BPN) is an accountable care organization that joins Arizona''s largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. This position is responsible to process health plan medical pre-service requests, provide case management, care coordination and perform utilization management duties within the appropriate time period as outlined in the Medical Management Program Descriptions, and in accordance with all federal and state regulations.
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.
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.
Care Manager, Telephonic Nurse 2 Humana IncCare Manager, Telephonic Nurse 2AZRemote$71,100–$97,800 / yearAs the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. In this pivotal role, you will support our Patient Management Program, focusing on individuals with specialized and complex health conditions, including autoimmune disorders, pulmonary diseases, neuromuscular disorders, infectious diseases, cancers, and other rare conditions.
Integrated Care Manager Blue Cross Blue Shield of ArizonaIntegrated Care ManagerPhoenix, ArizonaRemoteul>Within 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).
Sr. Compliance Specialist - Care Management Programs ValenzSr. Compliance Specialist - Care Management ProgramsPhoenix, AZRemoteFull time
Bilingual (Spanish) Advanced Practice Provider (NP or PA): Cardiology Devoted Health IncBilingual (Spanish) Advanced Practice Provider (NP or PA): CardiologyAZRemoteAs part of the clinic you will also provide dedicated clinical services during part of your clinical time to our heart failure clinic which is a highly tailored, specialty center focused on providing best in class heart failure management including optimizing guideline directed medical therapy, providing health coaching, and managing volume overload. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.
Bilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA) Devoted Health IncBilingual (Spanish) Primary Care Advanced Practice Provider (NP OR PA)Fully Remote, AZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerPhoenix, AZRemoteFull timeo Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.
Clinical Quality Study Analyst TriWest Healthcare AllianceClinical Quality Study AnalystPhoenix, AZRemoteFull timeTechnical Skills: General knowledge of Medicare, Veteran's Administration, TRICARE, or other government health care programs; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.
Clinical Quality Review Team Lead TriWest Healthcare AllianceClinical Quality Review Team LeadPhoenix, AZRemoteFull timeThe team lead supports clinical and non-clinical staff supporting CQM programs by providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.
Clinical Education Training Specialist TriWest Healthcare AllianceClinical Education Training SpecialistPhoenix, AZRemoteFull timeAssist with training department-specific needs, such as, maintaining required training documentation, maintaining both clinical and non-clinical training and orientation curriculum, participating in clinical operations leadership meetings, process improvement meetings, and other duties as appropriate and requested. In addition, this position requires designing, developing and presenting synchronous training courses relating to clinical and operational topics, and includes content, visual aides, exercises for the student and examinations.
Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP) Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.
NewBilingual (Spanish/English) Transitions of Care Advanced Practice Provider Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.
NewTransitions of Care Advanced Practice Provider Devoted Health IncTransitions of Care Advanced Practice ProviderAZRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.
Transitions of Care Advanced Practice Provider (APP) Devoted Health IncTransitions of Care Advanced Practice Provider (APP)AZRemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.
Speech Language Pathologist (SLP) - Teletherapy The Stepping Stones Group LLCSpeech Language Pathologist (SLP) - TeletherapyAZRemoteNew Jersey Asbury Park Atlantic City Barnegat Basking Ridge Bayonne BELLMAWR Bergenfield Berkeley Heights Blackwood Brick Bridgeton Bridgewater Butler Camden Cape May Court House Central Region Cherry HIll Chester Clementon Clifton Cranford Cresskill Deptford Dumont Dunellen East Brunswick East Orange Edgewater Park Edison Egg Harbor Township Elizabeth Englishtown Ewing Fair Lawn Flemington Franklin Lakes Freehold Garfield Gibbstown Gillette Hackensack Haddon Field Hainesport Hamilton Hammonton Hasbrouck Heights Haworth Hillsborough Holmdel Jamesburg Jersey City Lakewood Leonardo Lindenwold Little Egg Harbor Livingston Lodi Manalapan Manville Marlton Matawan Millington Millville Monmouth Monmouth Junction Monroe Township Montague Montclair Montville Morganville Mount Holly New Brunswick New Providence North Bergen Northfield Nutley Ocean Gate Oradell Parlin Parsippany Passaic Penns Grove Pennsauken Pequannock Perth Amboy Piscataway Pleasantville Point Pleasant Beach Pompton Plains Red Bank Ridgewood Rosenhayn Scotch Plains Skillman South Bound Brook South Orange Tenafly Tenefly Tinton Falls Toms River Tuckerton Union Vernon Verona Waldwick Wanamassa Watchung Wayne West Long Branch West New York Westampton Williamstown Willingboro Woodstown Wrightstown. Minnesota Aitkin Albert Lea Anoka Bemidji Bloomington Brooklyn Center Brooklyn Park Buffalo Burnsville Cedar Champlin Chaska Circle Pines Cloquet Cold Spring Columbia Heights Coon Rapids Cottage Grove Crosby East Grand Forks Eden Prairie Eden Valley Edina Elk River Faribault Forest Lake Hopkins Houston Hutchinson Inver Grove Heights Lakeville Mahtomedi Mankato Maple Grove Marine On Saint Croix Marshall Minneapolis Minnetrista Naytahwausch New Prague North Branch North St. Paul Oak Grove Onamia Osseo Princeton Prior Lake Red Wing Richfield Rochester Rollingstone Rosemount Roseville Rush City Saint Paul Sartell Sauk Centre Shakopee Shoreview South St. Paul Spring Lake Park St. Cloud St. Francis St. Louis Park St. Paul Stillwater Tofte Tower Wayzata West St. Paul White Bear Lake Willmar.
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–$3,686li>Perform 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 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–$3,686li>Perform 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.
Health Assistant - North Phoenix Great HeartsHealth Assistant - North PhoenixPhoenix, AZRemote$18–$25 / hourCompany Description Great Hearts Academies is a growing network of 45 public, open-enrollment, tuition-free schools in Arizona, Texas, and Louisiana. The school health assistants, as delegated by the Registered Nurse, are responsible for taking care of students and ensuring their good health and safety while on school premises.