Utilization Review Nurse

Iannarino Fullen Group; Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare organization is looking for a Registered Nurse with experience in behavioral health to provide compassionate virtual care for Arizona residents. This remote role requires strong clinical judgment and communication skills, with responsibilities including care coordination and compliance monitoring. Candidates must have a Bachelor of Science in Nursing and be located in the Greater Phoenix area. This is an excellent opportunity for RNs looking to make a difference in patient care.

Benefits

Equipment will be provided

Qualifications

• Must be located in the Greater Phoenix area.
• 1 Year of Behavior Health Experience.
• 2 Years of RN Experience.
• Valid Level 1 Fingerprint Clearance Card.
• CPR/BLS Card.
• Hepatitis B vaccination or declination of offered vaccine.

Responsibilities

• Provide monitoring and technical assistance for compliance with regulations.
• Conduct reviews and provide oversight.
• Gather and evaluate information from multiple sources.
• Coordinate care with stakeholders and make referrals as necessary.
• Participate in clinical staffing.
• Serve as a resource for necessary covered services.

Skills

Behavioral health experience

Strong clinical judgment

Excellent communication skills

Education

Bachelor of Science in Nursing Degree

Job description

Pay: $34.14 per hour (Weekly Pay)

Location: Remote (Must be located in the Phoenix Metropolitan Area)

Equipment will be provided

Job Description

We are looking for a Registered Nurse with behavioral health experience to support the State of Arizona by providing compassionate, evidence-based behavioral health care through virtual assessments, care coordination, and patient support.

This role requires the RN to be located in the Phoenix metropolitan area while collaborating remotely with multidisciplinary teams to monitor treatment plans and ensure continuity of care for Arizona residents. The ideal candidate is a licensed RN with behavioral health experience, strong clinical judgment, and excellent communication skills in a remote care environment.

Responsibilities

• 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
• Conduct reviews
• Provide oversight and technical assistance
• Gather, plan, organize and evaluate information from multiple sources (utilization data, case file reviews and audits)
• Coordinate care with external and internal stakeholders
• Make referrals as necessary
• Participate in clinical staffing
• Serve as a resource for medically necessary covered services

Required Qualifications

• Must be located in the Greater Phoenix area
• Bachelor of Science in Nursing Degree
• 1 Year of Behavior Health Experience
• 2 Years of RN Experience
• Valid Level 1 Fingerprint Clearance Card
• CPR/BLS Card
• Hepatitis B vaccination or declination of offered vaccine