Nursing Jobs in South Tempe, AZ
$60,200 - $107,400 / year
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Clinical Quality RN will be responsible for conducting quality of care (QOC) investigation, review and management of the regulatory Incident/Accident/Death (IAD) portal, documenting and communicating findings from these reviews, and preparing reports or summaries for internal and external customers. This position collaborates with the Chief Medical Officer or other Medical Directors to review QOC and other investigations and ensures that QOC investigations comply with all applicable State, Federal, and regulatory requirements. These activities are used to ensure care and services provided to our members are timely, adequate, and compliant with regulatory and professional standards and guidelines. If you are willing to work 8:00am - 5:00pm Mountain Standard Time zone, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities Perform clinical documentation review of inpatient and outpatient care delivered to adults and children with Medicaid, Medicare health care benefits through Arizona United Health Care Community Plans for peer review and internal investigations of Quality of Care concerns Create professionally written case investigation summaries for Peer Review, present case summaries at the Provider Advisory Committee as applicable Review plans of correction from providers in response to a substantiated QOC occurrence Effectively interface with external customers, facilities, members and providers to resolve quality of care concerns, obtain medical records and other information Conduct delegated oversight reviews of contractors that perform work on behalf of UnitedHealthcare. This includes reviewing samples of contractor work against an audit tool or information found in medical charts Collaborate internally with Medical Directors and staff in other UHCCP departments Manage multiple tasks and projects and changing priorities; prioritize work products effectively Maintain timeliness for deliverables and regulator requests Be able to work independently, good critical thinking skills, excellent verbal and written communication skills You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Active, unrestricted RN license in the state of Arizona or compact license 5+ years of experience working as a Registered Nurse 2+ years of hospital experience as a Registered Nurse Experience evaluating and auditing medical records Demonstrated intermediate skills in Microsoft Office, Word, and Excel ability to work with multiple databases to retrieve and enter information Demonstrated excellent writing skills - ability to analyze information and prepare written summaries Willingness to work a shift of 8am - 5pm Mountain Standard Time Preferred Qualifications 1+ years of experience in quality management and clinical quality investigations, or equivalent experience Proven knowledge of Medicare/Medicaid regulations Demonstrated solid understanding of quality improvement principles and practices Experience working in a deadline driven environment prioritizing responsibilities Experience in Behavioral Health Services All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN 
$90,604.80 - $136,011.20 / year
Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. Benefits Highlights Medical: Multiple plan options. Dental: Delta Dental or reimbursement account for flexible coverage. Vision: Affordable plan with national network. Pre-Tax Savings: HSA and FSAs for eligible expenses. Retirement: Competitive retirement package to secure your future. Responsibilities The Registered Nurse (RN) Case Manager works within an interdisciplinary team to facilitate the patient plan of care throughout the continuum of care by ensuring appropriate utilization management, care coordination, resource utilization, and clinical documentation. The RN Case Manager will function within the Mayo Clinical Nursing Professional Practice Model, which includes accountability for assessing, planning, implementing, evaluating, and communicating the patient care plan progression. The RN Case Manager utilizes the principles of mutual respect, patient/family advocacy and provides leadership within the team of internal partners and outside agencies to facilitate best practices that achieve quality clinical, financial, and patient satisfaction outcomes. The RN Case Manager provides leadership through education on case management/utilization management concepts, committee work, research, and community involvement. The RN Case Manager bridges communication between providers, patients and families, members of the interdisciplinary team, and outside agencies to assure high-quality care that meets the patient's needs and is delivered in a cost-effective and timely manner. The ANA Nursing: Scope and Standards of Practice and Code of Ethics provide a basis for the practice of the RN. The American Case Manager Association Standards of Practice and Scope of Services for Health Care Delivery System Case Management and Transitions of Care Professionals (2013) are reflected. This role is eligible for TN sponsorship. Qualifications Arizona: Graduate of an accredited, or those in the candidacy process, baccalaureate nursing program, as recognized by the Accreditation Commission for Education in Nursing (ACEN), Commission on Collegiate Nursing Education (CCNE), National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). If graduated from a nursing program that was not accredited by ACEN,CCNE, and NLN CNEA, at least one year of RN experience in an applicable care setting is required. If graduation did not occur within the last two years, one year of RN experience in an applicable care setting is required or, effective October 1st, 2017 one year of current LPN experience at Mayo Clinic is required. One year of RN Case Management experience or successful completion of the MCSHS RN Case Manager Fellowship within six months of hire required. 3 years of acute nursing preferred; 1 year of Case Management experience preferred. Certification (CCM or ACM-RN) preferred. Current RN license by applicable state requirements. Arizona - Maintains Basic Life Support (BLS) competency. Positions that are not on campus may not require current Basic Life Support (BLS) competency as determined by the work area. Additional state licensure(s) and/or specialty certification/training as required by the work area. ACH/ED coverage, case management experience preferred. ED experience preferred, strong communicator, demonstrates teamwork, collaborates well within interdisciplinary teams, adaptable/flexible to real time changes. Exemption Status Exempt Compensation Detail $90,604.80 - $136,011.20 / Year Benefits Eligible Yes Schedule Part Time Hours/Pay Period 48 Schedule Details Days Hours: 0700-1930 2 x 12 hour shifts per week Weekend Schedule 3 weekends required per 4 week schedule No call International Assignment No Site Description Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. Equal Opportunity All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the 'EOE is the Law' . Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. Recruiter Adisa Velic 