Utilization Review Nurse

Reference Number: RKAZUN15

Utilization Review Nurse

Not Disclosed

Phoenix, AZ (100% Remote)

3.0 Months

Not Disclosed

Not Disclosed

Government - State

$-4/hour - $1/hour

Job Description

Utilization Nurse (UR NURSE)

This position will provide monitoring and technical assistance to ensure compliance with contractual, regulatory, and statutory obligations for the FFS/SMI members’ physical/acute care services and behavioral health needs. Monitor over and underutilization, conduct reviews, provide oversight and technical assistance, gather, plan, organize and evaluate information from multiple sources, including utilization data, case file reviews and audits. Coordinate care with external and internal stakeholders as needed, make referrals as necessary, participate in clinical staffing as needed, serve as a resource for medically necessary covered services

Experience Required:
BSN Degree
2 years working as an RN
1-year minimum working in behavior health

Requirements:
Active RN license within the St of AZ

Notes:
100% Remote position, candidate will need to go onsite to get equipment.
Schedule: Monday- Friday 8:00am-5:00pm, No weekends

VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.