Salary: No Salary Noted
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What They’re Looking For
Candidates must hold an Associate or Bachelor degree in Nursing and possess a valid Registered Nurse license. At least one year of experience in Utilization Review or Case Management and three years of acute care nursing experience are required.
Skills to Bring
Utilization Review, Case Management, Medical Necessity Review, Clinical Documentation, Healthcare Regulations, Medical Record Review, Quality Outcome Measurement, Denial Management, DRG Classification, Patient Care Coordination, Physician Collaboration, Acute Care Nursing
Primary City/State:
Virtual ArizonaCategory:
Case ManagementShift:
DayDepartment:
Case Management

- Seeking Applicants That Can Work at Least 8 Shifts per Month
Great care starts with great people. (Like you.)
At HonorHealth, you’ll find something special. From humble beginnings in 1927 to one of Arizona’s largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most — caring for the health and well-being of people and communities across the greater Phoenix area.
Responsibilities:

- Reviews clinical documentation and facilitates modifications (as needed) to ensure that documentation accurately reflects the level of service rendered and severity of illness (in compliance with government and other regulations) for all patients. Performs initial and concurrent reviews on all patients entering the health care continuum.
- Facilitates the delivery of services to patients and families through effective utilization of available resources. Performs medical record reviews, as required by payer. Interfaces with Care Management team to provide information regarding quality outcome measurements (such as timeliness and appropriateness of services). Collaborates with physicians, case managers, payers and others to appeal individual denials and trended issues related to contract guidelines. Works with medical records, finance and physician groups to develop systems to facilitate complete documentation for data reporting purposes.
- Initiates chart reviews, conducts follow-up reviews, and rounds on patients to ensure continuity of UR reviews.
- Maintains a system to identify admissions with specific diagnosis / DRG classifications or other categories of admissions. Notifies attending physicians and house staff or other appropriate staff of documentation issues requiring clarification.
- Determines qualifications for hospital level of care based on set criteria.
- Performs other duties as assigned.
- Associates in Nursing from an accredited NLN/CCNE institution Required or
- Bachelors in Nursing from an accredited NLN/CCNE institution Preferred
- 1 year experience in UR/UM or Case Management Required
- 3 years Registered Nurse in an acute care setting. Required
- Registered Nurse (RN) – License State And/Or Compact State Licensure Required
- Certified Case Manager – Certification Certified Case Management (ACM) Case Management Certification Preferred
We're all in for your career.