Utilization review nurse jobs in Arizona - 676 jobs

Focus Staff is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Phoenix, Arizona. Job Description & Requirements Specialty: ICU - Intensive Care Unit Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours, nights Employment Type: Travel We currently have a client in PHOENIX, AZ looking for a Travel Neuro RN Registered Nurse! Focus Staff is seeking a traveling Certified Neuro RN, who will be responsible for daily oversight/management of the Neuro-Patient Population while working closely with nursing leadership to facilitate high-quality patient outcomes; work closely with neuro/neurosurgery physicians and extenders; identify areas of the patient experiences for improvement as related to education, process, discharge, etc. Contract Assignment - 13 Weeks (Temporary) Shift: 3x12 Nights Rewards: (Neuro RN) Pay depends on location and experience. Health Insurance Coverage 401K matching New licensing reimbursement Job staffing in all 50 states We are offering a very competitive package to the right licensed Certified Neuro RN. Candidates need to possess phenomenal efficiency and attention to detail with a strong knowledge of procedures and patient safety. Being Compassionate and sensitive is a prerequisite for the profession. The ideal Candidates goes a step further by being a critical thinker and fast to act with emergencies. Requirements: Motivated candidates who are looking for career growth AHA Current Basic Life Support certification for Health Care Providers BSN from accredited nursing program, and proper licensure Excellent communication skills with the staff, physicians, patients, and families Work Experience: At least 2 years of experience as a Neuro RN (Certified Neuro RN) If you are seeking a position as a Travel Neuro RN Registered Nurse and would like to work with an agency that will listen to your needs and career goals, then Focus Staff is the right place to be. We are proud of our ability to build relationships with all our healthcare professionals, whether you are seeking Travel assignments, PRN work or Permanent Placed positions. Responsibilities: Plans, implements, and evaluates patient care plans based on patient assessment to optimize outcomes and maximize available resources. Monitors, records, and communicates patient condition as appropriate. Collaborates as needed across disciplines to coordinate patient care, including patient transfer, discharge, referral and spiritual/psychosocial support needs. Evaluates learning needs of patient and/or family and provides patient/family education appropriate to age, culture, condition, and circumstances. Effectively delegates patient care to ancillary personnel. May precept student nurses and new hires. Job Type: Contract/Temporary/Travel Location: PHOENIX, AZ If You have a Passion for Nursing, Apply Today and a Recruiter will guide you through the Process. Join our VIP team of Traveling Professionals! Traveling Neuro RN, Neuro RN, Part-Time, Contract, Travel, Temporary, 13 Weeks, Temp. Tier3, Travel Neuro RN Registered Nurse Focus Staff Job ID #a0xVt00000Dy8BKIAZ. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN ICU - Intensive Care Unit Registered Nurse About Focus Staff Your Journey, Our Focus. Travel Confidently, Care Boldly with Focus Staff. At Focus Staff, we're here to make your travel healthcare career rewarding, seamless, and stress-free. Whether you're a travel nurse, therapist, or allied health professional, we take care of the details so you can focus on what you do best - caring for others. Our mission is simple: to help healthcare heroes like you thrive, no matter where your journey takes you. With thousands of job opportunities across all 50 states, our dedicated recruiters work closely with you to match you to the right assignment, based on what matters most to you - pay, location, benefits, or career growth. From day one, you'll enjoy premium benefits like medical coverage that bridges between assignments, 401K matching, travel and licensing reimbursements, and personalized housing support. Plus, our team is here for you 24/7, with clinical support available whenever you need guidance or backup. At Focus Staff, we believe in making every assignment a smooth, comfortable, and empowering experience. Let's make your next adventure your best one yet.

Stability Healthcare is seeking a local contract nurse RN ICU - Intensive Care Unit for a local contract nursing job in Phoenix, Arizona. Job Description & Requirements Specialty: ICU - Intensive Care Unit Discipline: RN Start Date: 01/26/2026 Duration: 13 weeks 36 hours per week Shift: 12 hours, days Employment Type: Local Contract Stability Healthcare is looking for a ICU RN contract position in Phoenix, AZ. Intensive Care Unit (ICU) Nurses treat acutely ill patients with life-threatening conditions, in settings requiring continuous vigilance and high-intensity therapies. ICU nurses can specialize in a variety of disciplines including medical, surgical, cardiac, burn or Neuro ICU. *$600 travel bonus *Day 1 health insurance with United Healthcare *PTO plan -- start accruing on day 1, use during contract or cash out at the end! *Guaranteed stipend if facility calls you off *Extra hour bonus -- earn an additional hourly bonus for working over your weekly contracted hours Stability Job ID #L-798532. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: ICU About Stability Healthcare Stability Healthcare was founded in 2009, with the mission of becoming the best Travel Nursing Agency in California. We have been rated one of the top travel nursing agencies and offer our nurses the highest paying travel nursing jobs available. We have access to the best travel assignments from 1000's of facilities. You can start the year off in sunny California, spend the Spring in the Colorado Rockies, enjoy the Summer in the Mid-West, experience the change of seasons in Boston and New York, and hit the beaches of Florida in the winter. Our Nurses work in the best hospitals and health systems in the country. Benefits Guaranteed Hours Benefits start day 1

GQR Healthcare is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Phoenix, Arizona. Job Description & Requirements Specialty: ED - Emergency Department Discipline: RN 36 hours per week Shift: 12 hours Employment Type: Travel GQR Uniti Med is representing a well-known health system seeking experienced Emergency Room providers to add to their team. If you are passionate about providing exceptional care and looking to explore a rewarding career opportunity, we‘d love to hear from you! Apply now, and a dedicated consultant will connect with you to discuss the role, answer your questions, and guide you through the process. About GQR Uniti Med: At GQR Uniti Med, we are committed to supporting healthcare professionals at every stage of their careers. When you partner with us, you gain access to a wide range of benefits and support, including: Day 1 Benefits: Enjoy comprehensive healthcare coverage, including medical, dental, and vision plans, starting on your first day. Guaranteed Hours: We provide contract stability by offering guaranteed hours, ensuring you have the predictability you need. Continuing Education & Development: We invest in your growth by offering opportunities for professional development and ongoing education. 24/7 Consultant Support: Our dedicated consultants are available around the clock to assist with any needs or questions you have. Seamless Placement Process: We handle all the details, from onboarding to interviews, so you can focus on what you do best - providing exceptional patient care. Partnering with GQR Uniti Med means more than just finding your next job - it‘s about building a meaningful career with a team that truly supports your goals. GQR Job ID #740322. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Registered Nurse (RN) About GQR Healthcare GQR's Healthcare team specializes in connecting experts within the industry to highly skilled healthcare professionals across the US market. In the competitive healthcare market, we recognize that the industry's common goals of improved quality of care and patient outcomes are wholly reliant upon the professionals directly supporting these initiatives. Leveraging our extensive candidate network, we deliver continuity of care for the communities our partners serve to ensure the patient experience is of the highest quality. Through deep market specialization and a unique approach to talent acquisition, GQR Healthcare provides an unparalleled and personalized experience across all medical specialties in nursing and within diverse healthcare platforms across the industry.

ADEX Healthcare Staffing LLC is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Phoenix, Arizona. Job Description & Requirements Specialty: ED - Emergency Department Discipline: RN Start Date: 01/05/2026 Duration: 13 weeks 36 hours per week Shift: 12 hours, nights Employment Type: Travel Opportunity: RN - ER Job Details: • Work 12-hour night shifts from 6:30 PM to 7:00 AM • Three days per week schedule with 4 weekend shifts required in a 4-week period (Friday and Saturday nights) • Position involves ZERO hands-on patient care - strictly bed placement coordination • Must have recent acute care experience (2 years preferred, minimum 1 year acceptable) • Required experience with TeleTracking and Cerner systems • Must be proficient with computers, Zoom, and Google applications • Strong multitasking and customer service skills required • Must understand different hospital departments and units (Med/Surg vs Telemetry, etc.) • Working with multiple screens and applications simultaneously • Coordinate patient placement in appropriate units across up to 3 hospitals managing 500-1000 beds • Use critical thinking to ensure appropriate bed assignments and communicate concerns to leadership • Self-scheduling after initial schedule assignment (subject to balancing) • Must be available to work holidays when needed with no PTO allowed for holidays • Pre-assignment modules required (3-4 hours, not billable) • DYS exam through UNA required prior to acceptance (must pass within 2 attempts) • 1 day general hospital orientation plus 3-5 days department training • BLS certification required • Professional scrubs or clean casual attire (jeans without holes, clean hoodies) acceptable • Hospital may cancel up to 4 shifts per 13-week assignment Facility: This healthcare organization operates a Clinical Command Center that coordinates patient placement across multiple hospital facilities. The facility manages bed assignments for hundreds of patients across several locations, utilizing advanced tracking systems and electronic medical records. The organization maintains 24/7 supervision and support, focusing on efficient patient flow management and optimal bed utilization across their network of acute care hospitals. Location: Phoenix, AZ Phoenix offers year-round sunshine and a thriving metropolitan environment with excellent outdoor recreation opportunities and a growing healthcare industry. The city provides a vibrant cultural scene, diverse dining options, and proximity to beautiful desert landscapes, making it an attractive destination for healthcare professionals seeking career growth in a dynamic urban setting. Adex Job ID #997040. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. About ADEX Healthcare Staffing LLC ADEX has been placing healthcare professionals across the US since 2004. Originally founded in Atlanta, GA, the company‘s headquarters are now located in Tampa, FL. JCAHO certified since 2009. Benefits Referral bonus

Uniti Med is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Phoenix, Arizona. Job Description & Requirements Specialty: ED - Emergency Department Discipline: RN 36 hours per week Shift: 12 hours Employment Type: Travel Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: Finding the right role is about more than just matching skills to a job-it's about aligning with your goals, values, and the way you want to work. As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. From our first conversation to your first day on the job (and beyond!), we're here to help you move forward with confidence. UnitiMed Job ID #740322. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Registered Nurse (RN) About Uniti Med Uniti Med meticulously matches your talents to our open needs to ensure the ultimate travel experience. Tell us where you want to go and let our experienced staff lead the way! Benefits Referral bonus Benefits start day 1 Employee assistance programs

Assured Nursing is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Globe, Arizona. Job Description & Requirements Specialty: ICU - Intensive Care Unit Discipline: RN 36 hours per week Shift: 12 hours, nights Employment Type: Travel Assured Nursing is currently seeking a RN for a contract position in Globe Arizona. This is a 7p-7:30a, 19:00:00-07:30:00, 12.00-3 position in the Intensive Care / Coronary Nurse (ICU). The ideal candidate will possess a current state license as a RN and have at least 2 years of recent experience as a ICU RN. Assured Nursing Job ID #35461188. Pay package is based on 12 hour shifts and 36.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:ICU,19:00:00-07:30:00 Benefits Weekly pay Holiday Pay 401k retirement plan Referral bonus Medical benefits Dental benefits Vision benefits

American Traveler is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Globe, Arizona. & Requirements Specialty: ICU - Intensive Care Unit Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours, nights Employment Type: Travel Job Description American Traveler is seeking an experienced ICU RN for night shifts, requiring an active AZ or compact RN license and 3 years of recent ICU experience. Responsibilities Work in the Intensive Care Unit (ICU) of a hospital setting Patient population includes critically ill adults requiring intensive monitoring and care 12-hour night shifts with additional call requirements Must be willing to float to Med Surg as needed EMR system used is Meditech 6.0; experience preferred Must take some 24-hour call shifts during assignment Flu vaccination is required with no exceptions RTO requests limited to 3 days for the duration of the 13-week contract A 100-mile radius rule is in effect; candidates must not reside within 100 miles of the facility Will work alongside a multidisciplinary ICU team On-call shifts are required in addition to scheduled shifts Requirements Active AZ or compact RN license required Minimum of 3 years current ICU nursing experience Current ACLS and BLS certifications required Must have an active nursing license prior to assignment Meditech 6.0 EMR experience is preferred Benefits High Pay and Bonuses Medical, Dental and Vision Insurance with Day 1 Options 401(k) Plan Weekly Payroll Deposit Free Online CEUs Generous Housing Allowance Travel and Licensure Reimbursements Non-taxed Per Diem and Subsidy Traveler Rewards and Discounts American Traveler Job ID #P-657747. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - ICU About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers. With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements. American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment. With our team behind you, you can relax and enjoy a rewarding travel career.

Access Healthcare is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Globe, Arizona. Job Description & Requirements Specialty: ICU - Intensive Care Unit Discipline: RN 36 hours per week Shift: 12 hours, nights Employment Type: Travel Access Healthcare Job ID #75104998. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. About Access Healthcare Access Healthcare aims to provide superior service to our nursing family by providing around the clock support, competitive pay packages and an unmatched benefits package! Unlike other agencies, we offer a true family feel and work with you to find the placement that is right for you. We offer one of the top leading pay packages in the industry and we are ready to get you the money you deserve! Access Healthcare was founded by two travel nurses, Danielle and Diego, who had a dream and a shared vision of creating an agency which all nurses would want to work with. Our passion has led us to where we are today as one of the top 10 agencies in our home state of New Jersey, with access to contracts in all 50 states! We encourage you to join our team and we cannot wait to get to know you!

Anders Group is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Globe, Arizona. Job Description & Requirements Specialty: ICU - Intensive Care Unit Discipline: RN 36 hours per week Shift: 12 hours, nights Employment Type: Travel Anders Group Job ID #982422. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: ICU RN-Nights About Anders Group WHY ANDERS? Anders Group is a Joint Commission accredited staffing agency and stands out from other agencies by our commitment to making sure our travelers are given the best customer service. Our team works hard to find the best jobs with the most aggressive rates! Anders Group offers rewarding assignments and competitive compensation packages, nationwide! We offer the following benefits from day one: Health Insurance, Including a Buy-up Option Dental Insurance Vision Insurance Life Insurance 401(k) Licensure Reimbursement Premium Pay Packages CEU Reimbursements Daily Per Diems Travel Reimbursements Rental Car Allowances Continuing Education Resources Referral Bonus And Many More! THE ANDERS DIFFERENCE You're committed to providing exceptional healthcare. We're committed to you. Anders Group was founded by a team of healthcare recruiters who had built strong relationships with healthcare facilities and professionals nationwide. As staffing firms shifted their focus to numbers and margins, these recruiters saw a need for a company to take a different approach to staffing. Anders Group was founded in 2010 to do just that. We focus on individual and facility goals to make quality placements. Great people working with great facilities make for the best placements. Through our focus on providing the best experience to Allied and Nursing health care professionals, Anders Group has grown to be a top staffing firm in Healthcare. We look forward to working with you! Benefits Medical benefits Dental benefits Vision benefits Life insurance 401k retirement plan License and certification reimbursement Continuing Education Referral bonus

Aequor Healthcare is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Chandler, Arizona. Job Description & Requirements Specialty: ICU - Intensive Care Unit Discipline: RN Start Date: Duration: 13 weeks 36 hours per week Shift: 12 hours Employment Type: Travel **All positions require at least two proven years experience** Aequor Job ID #. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Registered Nurse (RN) - ICU About Aequor Healthcare Aequor Travel Nursing is a premiere healthcare staffing agency that specializes in placing healthcare travelers in short term contracts throughout the US. Whether you're a seasoned healthcare professional looking for your next great adventure or just starting out and looking for your first big opportunity, Aequor has the inside track on the top jobs available in today's healthcare and clinical markets. At Aequor, our top priority is to be the best resource to help you connect with the perfect career opportunity and take the best care of you from the moment we first connect until your last shift is worked. We pride ourselves on always offering top industry competitive pay. We have positions for nationwide covering every single state and ranging from 4 weeks - 26 weeks. Benefits Weekly pay Holiday Pay 401k retirement plan Referral bonus Medical benefits Dental benefits Vision benefits

The RN Admissions Nurse supervises, implements, coordinates, and manages patient care through interpersonal contact with patients, families, nursing staff, and others in accordance with all applicable laws, regulations, and Life Care standards. Education, Experience, and Licensure Requirements Nursing diploma (associate's or bachelor's degree in nursing) Currently licensed/registered in applicable State. Must maintain an active Registered Nurse (RN) license in good standing throughout employment. One (1) year geriatric nursing experience preferred CPR certification upon hire or obtain during orientation. CPR certification must remain current during employment. Specific Job Requirements Expert knowledge in field of practice Make independent decisions when circumstances warrant such action Knowledgeable of practices and procedures as well as the laws, regulations, and guidelines governing functions in the post acute care facility Implement and interpret the programs, goals, objectives, policies, and procedures of the department Perform proficiently in all competency areas including but not limited to: patient rights, and safety and sanitation Maintains professional working relationships with all associates, vendors, etc. Maintains confidentiality of all proprietary and/or confidential information Understand and follow company policies including harassment and compliance procedures Displays integrity and professionalism by adhering to Life Care's Code of Conduct and completes mandatory Code of Conduct and other appropriate compliance training Essential Functions Provide hands on assessment care to patients during the admissions process Effectively communicate assessment findings with physician Knowledgeably and competently deliver quality nursing care to patients Evaluate patients' needs assessment and initiate care plans upon patient admission and readmission Accurately receive, document, and transcribe physician orders Communicate orders to others timely to ensure timely receipt of medications and order implementation Chart appropriately and timely Exhibit excellent customer service and a positive attitude towards patients Assist in the evacuation of patients Demonstrate dependable, regular attendance Concentrate and use reasoning skills and good judgment Communicate and function productively on an interdisciplinary team Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours Read, write, speak, and understand the English language An Equal Opportunity Employer

Full-time Description Axiom Care is a fast-paced, rapidly growing substance abuse treatment and sober living housing provider with locations in the Phoenix metro area and Apache Junction. We primarily serve low-income and justice-involved individuals who are seeking to change their life for the better. We achieve this by offering multiple levels of care along with medical services, evidence-based professional counseling, case management, housing assistance, employment assistance, and more. Job Summary The UR Coordinator's primary responsibility is managing, reviewing, and monitoring utilization of patient resources and obtaining payor authorization as required for all provided services. The UR Coordinator will function as liaison between payor source(s), the finance office, and the clinical treatment team, providing information and feedback to assist in optimum patient care and reimbursement. Duties/Responsibilities Review of patient admission data and clinical documentation to ensure compliance with insurance and governmental regulations relating to medical necessity and case documentation. Collect and compile data needed for prior authorization, concurrent review, discharge notifications and retrospective reviews. Ensure all authorization requests have been completed for inpatient and outpatient services, according to applicable facility and insurance policies. Maintains detailed and complete documentation regarding the UR process for each case. Actively communicate with interdisciplinary team regarding patient diagnosis, utilization of services, length of treatment, authorization status and case documentation. Participation with departmental staff in quality improvement meetings and projects. Preparing memorandum, letters, correspondence, and comprehensive UR status summaries. Other duties as assigned. Supervisory Responsibilities None. Requirements Required Skills/Abilities: Demonstrate positive and professional written, verbal and nonverbal communication skills. Navigate and effectively utilize relevant software such as Office 365, SmartSheets, Kipu, and Collaborate MD. Maintain effective interpersonal relationships with the clinical, medical, and administrative teams. Understand and apply state, federal, and local regulations and laws governing quality assurance and utilization review. Work independently. Analyze treatment plans and evaluate elements of assessment which include the diagnosis of client behavioral and emotional problems. Confidently alert appropriate clinical staff to expedite care and facilitate timely and accurate documentation of patient status. Use good judgment in order to make critical decisions about the medical necessity of treatment. Provide ongoing updates and notifications in the Sigmund Electronic Management system. Education and Experience High school diploma or equivalent. Utilization Review: 1-2 years preferred. Knowledge of: Psychological and social aspects and characteristics of mental illness and chemical dependency. Principles and methods of counseling and the accepted techniques for assessing psycho-social behavior. Human behavior and development. Problems, needs and attitudes of chemically dependent and dually diagnosed. Pertinent laws and regulations regarding health and social service programs. Federal, state and county regulations pertaining to utilization review. Methods and procedures of admissions, discharges and patient care in outpatient and inpatient behavioral health facilities. Medically Necessary Criteria of major third-party funding sources. Required Competencies: Analytical Thinking - Uses logical reasoning to process, break down, and work through a situation or problem to arrive at an outcome. Communication - Clearly conveys and receives information and ideas through a variety of media to individuals or groups in a manner that engages the listener, helps them understand and retain the message, and invites response and feedback. Keeps others informed as appropriate. Demonstrates good written, oral, and listening skills. Collaboration - Builds constructive working relationships with clients/customers, other work units. Follow-up and case management of assigned patients and payers, to include authorizations, denial and the appeal process and follow up. Shows understanding in Medicaid plans medical necessity guidelines and Axioms forms needed to convey criteria. Ability to manage assigned MCO, precertification, concurrent review, Discharge clinical, Prior authorizations for stepdown. Physical Requirements: Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times.

The UR Authorization (Auth) Coordinator is the key position for reviewing admissions and utilization authorizations throughout Sanctuary facilities. The UR Auth Coordinator is responsible for reviewing clinical documentation, communicating with various sites, and securing and processing authorizations for inpatient, residential, and all other services that request payor authorization. The UR Auth Coordinator secures and monitors pre-certifications, concurrent reviews, retro reviews, and appeals to ensure that the members are getting timely, appropriate care. The UR Auth Coordinator serves as a communication liaison between Sanctuary Recovery Centers and the assigned payors. The UR Auth Coordinator will continue to seek knowledge of the industry, assigned payors, and maintain a strong knowledge of the overall departmental and organization functions. Process and Practice Development Responsible for making recommendations for process improvements and report any barriers experienced by the UM department. Responsible for coordination of the flow of patients from medical management teams, completes referral in the EMR, collects medical records for completeness, identifies availability of appropriate bed placements and ensures timely review for acceptance/notification of denials. Ensures all coordination of care & authorizations are documented accordingly prior to departure of each shift. Responsible for maintaining call logs, productivity reports and status reports. Attends weekly staff meetings and at least one UM Team meeting per month in person. Protects each patient's confidentiality within the parameters of federal guidelines and established policy and process. Adheres to established policy and process for this assignment. Other duties as assigned by supervisory and administrative support. Pre-certification of Services (Authorizations) Responsible for ensuring that Sanctuary Recovery Center's has obtained authorization for medically necessary services provided to patients. Ensures Notice of Admissions are submitted as appropriate within the required timelines of the payors. Reviews admissions daily for each assigned program to ensure that any pre-certification is completed appropriately. Reviews bed board daily to ensure that length of stay for each program is within authorized duration. Additionally, provides notice to program management and staff regarding upcoming and overdue authorization expirations. Prior Authorization (PA) forms by payor are completed by appropriate medical staff, and submission to the respective payors of services within the required timelines established by that payor. Provides educational support to staff on admission criteria for each level of care that incorporate medical criteria to meet each of the contracted payors and private insurance standards. Requests retro reviews from Medical Records and mails them to the requesting payors. Documents each mailed out retro review and complete follow up to ensure review was received by appropriate party and authorization is obtained. Pulls admit/discharge report daily and verifies all private insurance admits had insurance verified and authorization obtained. Completes daily spreadsheet that lists private insurance admits and what follow up is still needed. Ensures each authorization obtained and status of any pending authorizations is documented in EMR. Skills/Requirements High School diploma or GED required. Associates Degree (or higher) in a field related to Business or Health Care preferred. 3 or more years of administrative work history, such as front office, secretary and/or clerical preferred. 1 or more years of experience in healthcare setting preferred. Or equivalent combination of education and experience

Are you looking for a change of pace? Do you have a passion for helping people? Look no further! Pinnacle Peak Recovery is a mental health and substance use treatment provider located in Scottsdale, Arizona. If the following values are important to you then you will be a great fit for our company culture. Compassion Fun Collaborate Integrity Our hiring process is centered around our core values. We do this to ensure a good culture fit, which in turn creates an unmatched work environment. With our comprehensive onboarding process and support staff you will feel: Informed - Confident - Empowered - "Ice Ice Baby!" Our program focuses on a comprehensive and holistic approach to overcoming addiction and mental health disorders in a safe, confidential, and supportive environment. We offer nationally recognized, evidence-based treatment options including MAT. Our clinic aspires to the highest level of care and is proud to have received accreditation from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Position Overview: The Utilization Review Coordinator is an analytical, detail-oriented and organized professional responsible for all Utilization Review functions. The UR Coordinator is responsible for, but not limited to pre-certification, and initial and concurrent reviews for client's treatment. This position works as part of the billing team and closely with the clinical and medical teams to act as a liaison between Pinnacle Peak Recovery and the insurance organizations. Duties and Responsibilities: Reviews benefit verification with insurance organizations for covered services and precertification requirements. Inputs reviews into the Utilization Review calendar to ensure timely scheduling of reviews. Gather and analyze all information in client chart. Ability to review client records in depth and work with treatment team to gather required medical and clinical information to support client's admission and continued stay. Working knowledge of DSM IV Axis I-V, DSM V, ICD-10 and ASAM criteria. Broad understanding of dual-diagnosis issues and treatment protocols. Assess and distinguish levels of care for clients based on clinical and medical assessments and information using ASAM criteria. Coordinates obtaining signed releases of information for the patient to facilitate timely communication of clinical and medical information. Complete initial and concurrent reviews with insurance organizations as scheduled to ensure client level of care authorization and length of stay. On an ongoing basis, identify potential review problems and discuss them with supervisor and applicable departments. Coordinates peer to peer and/or doctor to doctor reviews with insurance organizations and medical and/or clinical treatment team. Document contact and outcomes of reviews with insurance organizations as indicated in a timely manner. Completes retro authorization appeals as needed. Creates, maintains, and tracks various utilization review reports. Able to interact with diverse client population. Assists with completing various client assessments. Assists with various chart audits and reports. Occasionally assists with insurance Verification of Benefits. Participate in department in-service/training programs and various staff meetings. Attend continuing education classes to maintain license and/or certification, if applicable. Complete special assignments and responsibilities as requested by supervisor. Performs other duties as assigned. Skills and Abilities: Strong communication, including writing, speaking and active listening. Strong problem-solving and critical thinking skills. In-depth knowledge of insurance and best practices. Must be detail oriented and familiar with databases and extrapolating data. Strong interpersonal, organization, analytical, time management and prioritization abilities. Strong teamwork and organizational awareness. Excellent judgment and initiative. Functions as a core member of the health care team. Regularly communicate with other team members and interface in a positive, constructive, and helpful manner to promote collaboration, cohesiveness, reduce conflict, and provide for resolution. Able to work under pressure and meet deadlines as well as be flexible and dependable. Demonstrate the ability to understand and react effectively to the unique needs of the clients and team. Strong writing skills and understanding of clinical and medical terminology. Understanding of CPT, HCPCS, Revenue Codes, and insurance procedure guidelines. Strong understanding of DSM IV Axis I-V, DSM V, ICD-10 and ASAM criteria. Knowledge of Joint Commission standards. Strong knowledge and compliance of HIPAA, ethic, and legal protocols. Basic math and strong computer skills (Billing systems, Email, Microsoft Office Word, Excel, Teams, etc.) Ability to use standard office equipment such as copier, fax machine and other equipment as required. Education and Requirements: High School Diploma or GED equivalent required. Minimum 2 years' experience working in Utilization Review. Compensation: 45k-60k Base Salary

Vālenz Health is the platform to simplify healthcare - the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey - from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible. About This Opportunity: As a Utilization Management Nurse, you will have a meaningful impact each day by delivering comprehensive, patient centered care. You'll assess individual needs, shape personalized care plans, and bring together the right healthcare partners to keep patients moving forward. With your clinical insight, you'll help members navigate the healthcare system with confidence, reinforce treatment plans, and champion high quality outcomes through clear communication, education, and steady support. You'll also play an important role in promoting wellness, using resources wisely, and ensuring we meet both regulatory and organizational standards. You'll also have the chance to work on a wide variety of cases, which is a great way to build new skills, expand your clinical thinking, and grow your expertise over time. Things You'll Do Here: Review prospective, concurrent, and retrospective UM cases and apply the appropriate criteria and plan documents. Work with providers and internal partners to make sure the right guidelines are used within the required timelines. Support quality care and cost-effective outcomes that help members stay healthy and engaged. Follow CMS, URAC, and other regulatory requirements tied to UM activities. Flag any potential overuse, underuse, or misuse of services. Identify high risk, catastrophic, or disease management cases and route them to the right teams. Communicate UM decisions clearly with providers and members so everyone stays aligned. Document UM activities accurately and maintain confidentiality at all times. Participate in ongoing education to keep your UM knowledge fresh and current. Help support smooth transitions of care for inpatient members, including early discharge planning. Bring forward any potential quality or patient safety concerns. Take on additional responsibilities as needed to support the team. Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties. What You'll Bring to the Team: 3+ years of clinical nursing experience. 1+ years of UM experience Active, Unrestricted RN License in your state of residence. Ability to work in a fast-paced, detailed, deadline-driven environment. Ability to maintain strict confidentiality and handle sensitive information with discretion. Experience working independently with strong problem solving and organization skills. Strong aptitude for relationship building with a highly effective communication style. A plus if you have: Utilization Management or Case Management Certification. Where You'll Work: This is a fully remote position, and we'll provide all the necessary equipment! Work Environment: You'll need a quiet workspace that is free from distractions. Technology: Reliable internet connection-if you can use streaming services, you're good to go! Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software. Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA. Schedule: This role follows a full time, Monday through Friday schedule during standard business hours. Below you'll find the schedule according to your time zone. EST: 9:30am to 6pm CST: 8:30am to 5pm MST: 7:30am to 4pm PST: 6:30am to 3pm Why You'll Love Working Here Valenz is proud to be recognized by Inc. 5000 as one of America's fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare . With this commitment, you'll find an engaged culture - one that stands strong, vigorous, and healthy in all we do. Benefits Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card. Spending account options: HSA, FSA, and DCFSA 401K with company match and immediate vesting Flexible working environment Generous Paid Time Off to include vacation, sick leave, and paid holidays Employee Assistance Program that includes professional counseling, referrals, and additional services Paid maternity and paternity leave Pet insurance Employee discounts on phone plans, car rentals and computers Community giveback opportunities, including paid time off for philanthropic endeavors At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.

Job Address: 4770 Larimer Pkwy Johnstown, CO 80534 New Vista Health and Wellness is currently recruiting a Utilization Review Coordinator! WHO WE ARE The New Vista mission: Inspiring Hope, Restoring Peace of Mind, Healing Lives. At New Vista, our passionate and highly trained team of professionals inspires hope and delivers holistic care to those in need of behavioral health services in a contemporary and healing environment - one that is conducive to providing the life skills needed to regain stability and independence. With a blend of group therapy, clinical treatment, and unique surroundings, our beautiful healthcare centers provide a safe, serene, healing environment for adults and seniors with a variety of complex needs. Our compassionate team members work in a challenging yet rewarding environment where each person is a part of making direct impact on our patient's lives. COME JOIN OUR TEAM AS UTILIZATION REVIEW COORDINATOR AT SIERRA VISTA! Salary: Up to $46K PERKS AT WORK Team Members enjoy a variety of perks in working with the NewVista brand company. We offer competitive market wages along with a full, robust package: Healthcare + Life Balance Medical Packages with Rx - 3 Choices Flexible Spending Accounts (FSA) Dependent Day Care Spending Accounts Health Spending Accounts (HSA) with a company match Dental Care Program - 2 choices Vision Plan Life Insurance Options Accidental Insurances Paid Time Off + Paid Holidays Employee Assistance Programs 401k with a Company Match Education + Leadership Development Up to $15,000 in Tuition Reimbursements OR Student Loan forgiveness Handle with Care Trainer - Certifications Recognition + Rewards On the spot recognition Prizes Team Member of the Quarter Team Member of the Year Monthly Celebrations Team Member Recognition Cards Education High school diploma or GED (Required) Bachelor's Degree in Nursing, Social Work, Mental Health/Behavioral Sciences, or related field preferred. Previous Utilization Review experience in a behavioral healthcare facility preferred. JOB RESPONSIBILITIES As Utilization Review Coordinator, you will : Obtain initial authorizations and provide discharge notifications for inpatient and outpatient behavioral health treatment. Coordinate authorization information with third party payors in a timely manner. Complete thorough and accurate documentation in all required systems. Maintain communication system based on documentation and verbal exchange regarding treatment with other UM staff and staff at the facilities as needed. Reports appropriate denial and authorization information to designated resource. Assist UM Specialists in scheduling and following up on results of Peer to Peer requests for physicians and CNP. Provide support to the UM Specialists. Skills: Ability to multi-task Strong organization skills Strong problem-solving skills Ability to work well independently and as a part of a team Qualified candidates, apply now for a chance to join our outstanding team as we Inspire Hope, Restore Peace of Mind, and Heal Lives.

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Case Management - Nurse, Senior will report to the Manager of Care Management. In this role you will play a pivotal role in assessing member needs, providing clinical education, as well as care coordination with providers, medical groups, and community resources. You will be responsible for managing and coordinating patient care, ensuring that our members receive the highest quality of care and services. Care Managers perform care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians. Your Knowledge and Experience Requires a current and valid CA RN License or valid RN license(s) from other state(s). Preferred licensure from a compact state. If assigned to another state, must maintain an active, unrestricted RN license in assigned state(s) or the ability to obtain required RN license (in addition to primary state license) within 90 days of hire Bachelor of Science in Nursing or advanced degree preferred Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements Requires 5 years experience in nursing, healthcare, or related field A minimum of 3 years managed care experience in inpatient, outpatient, or managed care environment preferred Health insurance/managed care experience preferred Transitions of care experience preferred Strong knowledge of healthcare delivery systems, managed care principles, and care coordination Excellent communication skills Your Work In this role, you will: Determine appropriateness of referral for CM services, mental health, and social services Assess members health behaviors, cultural influences and clients belief/value system. Evaluate all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers Research and design treatment/care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type. Adjust plans or create contingency plans as necessary Identify appropriate programs and services that align with member needs and preferences Initiate timely Individualized Care Plans (ICP) based on Health Risk Assessment (HRA) completion, participation in and documentation of Interdisciplinary meetings (ICT), assisting in transitions of care across all ages Provide Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD) Conduct member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases Research opportunities for improvement in assessment methodology and actively promote continuous improvement. Anticipate potential barriers while establishing realistic goals to ensure success for the member, providers, and BSC Determine realistic goals and objectives and provide appropriate alternatives. Actively soliciting client's involvement Recognize need for contingency plans throughout the healthcare process Provide education and support to members and their families regarding health conditions, treatment options, and community resources Follow up with members as appropriate to ensure they have successfully connected with recommended programs and services

About us: Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more! Responsibilities The Utilization Review Nurse's duties will include, but are not limited to: Support internal claims adjusting staff in the review of workers' compensation claims Review records and requests for UR, which may arrive via mail, e-mail, fax, or phone Meet required decision-making timeframes Clearly document all communication and decision-making within our insurance software system Establish collaborative relationships and work as an intermediary between clients, patients, employers, providers, and attorneys Utilize good clinical judgment, careful listening, and critical thinking and assessment skills Track ongoing status of all UR activity so that appropriate turn-around times are met Maintain organized files containing clinical documentation of interactions with all parties of every claim Send appropriate letters on each completed UR Qualifications Active Licensed Practical Nurse and/or Registered Nurse License 1+ years of utilization review experience at a managed care plan or provider organization 2 + years' clinical experience preferably in case management, rehabilitation, orthopedics, or utilization review Excellent oral and written communication skills, including outstanding phone presence Strong interpersonal and conflict resolution skills Experience in a fast-paced, multi-faceted environment The ability to set priorities and work both autonomously and as a team member Well-developed time-management and organization skills Excellent analytical skills Working knowledge of: Microsoft Word, Excel, and Outlook

Join us in the enchanting town of Kingman, for an extraordinary career as a Flight Nurse with Air Methods. $8,000 Sign-On Bonus and $6,000 Location Stipend Nestled amidst the majestic landscapes of Kingman, AZ offers a perfect blend of natural beauty and cultural richness. As a pivotal member of our team, you'll play a crucial role in providing life-saving medical transport to the community. With a minimum of 36 months of experience in a busy ICU, ER, Flight, or Critical Care Transport setting within the last 5 years, your expertise will be invaluable. Operating on a schedule of two 24-hour shifts per week, you'll deliver top-notch critical care, adhering to the highest standards set by Air Methods Community Base Services (CBS) Medical Director(s). Your responsibilities will encompass assessment, triage, and treatment, ensuring the safe transport of critical patients to the appropriate medical facility. From the unique vantage point of a helicopter, you'll enjoy breathtaking views of the scenic Arizona landscape, enhancing the experience of your daily work. Join us in Kingman, where every flight underscores our commitment to excellence and safety in medical transport. Experience the thrill of flight while making a significant impact on the well-being of those in need in this dynamic and culturally rich community. Responsibilities Job Summary Responsible for providing high-quality critical care, including assessment, triage, and treatment utilizing standards and guidelines established by Air Methods Community Base Services (CBS) Medical Director(s). You'll assess the nature and extent of illness or injury to establish and prioritize the care needed for the safe transport of the critical patient to the appropriate facility and are responsible for carrying out the mission and goals of Air Methods CBS, assuring that safety remains the highest priority throughout the transport continuum. Essential Functions and Responsibilities include the following: * Provides nursing care within his/her scope of practice from the initial contact until patient care is relinquished to the accepting medical facility; maintains thorough patient care documentation. * Maintains competency in knowledge and psychomotor skills by participating in ongoing laboratory and clinical experiences. Communicates educational needs to the Medical Base Supervisor and Medical Education Coordinator. Maintains documentation of required licensure, certifications, continuing education, aviation and safety training, OSHA and HIPAA training, clinical rotations, and advanced procedures and attends continuing education programs pertinent to his/her area of practice. * Knowledgeable in using and maintaining all equipment and supplies used by Air Methods CBS. Responsible for reporting medical equipment failures and taking initial steps to ensure equipment repair as directed. Maintains adequate supplies onboard aircraft to deliver patient care. Keeps aircraft clean and orderly to ensure rapid response to all transport requests. * Functions as a medical flight member by attending pre-mission briefings and mission debriefings and completing necessary documentation. Assists in pre-mission liftoff checklist and assists pilot as requested, i.e., radio, navigational, and visual observation activities. Complies with safety standards to assure the safety of self, medical personnel, patients, and equipment and conducts aircraft safety briefings as needed. * Serves as a flight resource to neonatal/pediatric personnel when transporting specialty patients by helicopter and performs advanced skills and procedures as approved by Air Methods CBS Medical Director(s). * Participates in patient and referring institution follow-up and in planned outreach marketing and education activities * Acts as a preceptor and/or participates in orientation of new employees and students as assigned and communicates program goals and objectives. * Participates regularly in Air Methods CBS meetings, activities, projects, and committees (to include research and publishing opportunities). * Other Duties as assigned. Additional Job Requirements * Regularly scheduled attendance * Indicate the percentage of time spent traveling: 5% * Subject to applicable laws and Air Method's policies, regular attendance is an essential function of the position. All employees must follow Air Methods' employment practices and policies. Supervisory Responsibilities * This position has no supervisory responsibilities. Qualifications Qualifications To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements below represent the required knowledge, skill, and/or ability. In accordance with applicable laws, Air Methods will provide reasonable accommodations that do not create an undue burden so disabled employees may perform the position's essential functions. Education & Experience * Graduate of an accredited School of Nursing * Bachelor's degree in a health-related field preferred but not required * Minimum three (3) years of recent critical care/emergency nursing experience within the last five years or as required by state/ local EMS regulations * Pre-hospital experience preferred * Flight experience is not required but is a plus! Operation and Safety Requirements: * As a member of the Clinical Flight Crew, any person employed in this position shall maintain a weight not to exceed 225 pounds, including an empty flight suit and boots. Skills Skills as required to practice nursing as defined by assigned state scope of practice and advanced practice skills as defined by Medical Director(s) and Medical Standards * Maintains positive interpersonal relationships with colleagues, EMS representatives, hospitals, and the public while executing strong interpersonal skills and a high degree of collaboration at all levels * Demonstrates high critical thinking and reasoning skills and strong attention to detail while working in a fast-paced environment that requires the ability to prioritize and multi-task * Ability to work a flexible schedule, including overtime and 24/7 on-call rotation * Dependable and self-motivated while working in a frequently changing environment * Excellent communication and presentation skills, both written and verbal Computer Skills * Proficient with Microsoft Suite, including Word, Excel, PowerPoint and Outlook Certificates, Licenses, Registrations * Current RN license(s) for states of practice * EMS or MICN certification/licensure as required by state regulations * Current certifications in Healthcare Provider BLS/CPR; ACLS; PALS or equivalent (AHA, ARC, or ASHI only courses if state or county required) and TPATC/TNCC/ITLS/PHTLS advanced provider (if state or county required) * If you do not have a current trauma certification, Air Methods will provide the TPATC online course to be completed prior to new hire orientation Other certification requirements: * Specialty certification (CFRN or CEN) are required within 24 months of hire * Advanced Trauma Course requirement: One (1) of the following certifications are acceptable: TPATC, TNCC, ATCN, TNATC, or CAMTS-approved advanced trauma course before completion of third-rider training * NRP certification before completion of the third-rider orientation * NIMS Training IS 100, 200, 700, 800, and HazMat before completion of third-rider training Benefits Air Methods is proud to offer a comprehensive benefits package created with the diverse needs of our teammates in mind: * Health, Dental and Vision * Competitive 401(k) Retirement Plan * Flexible Spending Account Benefit Plans * Tuition Reimbursement * Full Company-Paid Life Insurance * AD&D Insurance * Short-Term and Long-Term Disability Insurance * Business Travel Accident Insurance * Voluntary Legal * Relocation Assistance * Employee Assistance and Benefit Concierge Service Programs Minimum pay USD $77,750.40/Yr. Maximum Pay USD $95,022.72/Yr. Benefits For more information on our industry-leading benefits, please visit our benefits page here. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)