Utilization Nurse (UR NURSE)

Location: Phoenix, AZ 85034 (Remote) AZ Only.

3+ Months

Day Shift

Schedule: Monday- Friday 8:00am-5:00pm, No weekends

100% Remote position, candidate will need to go onsite to get equipment.

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 state of Arizona

- FPCC

Required Skills

Active RN Licenses in the State of AZ

1 year minimum of Behavior Health experience