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The Utilization Review Nurse acts as a liaison in the coordination of resources and services to meet patients’ needs, promotes teamwork to optimize efficient and cost-effective use of health care resources, monitors the health care delivery plan to maximize positive patient outcomes, and maintains compliance with applicable laws and regulations and the policies of Professional Health Care Network. The clinician will monitor adherence to ensure the effective and efficient use of home care-based services and monitor the appropriateness of homecare admissions, resumptions of care, reauthorizations, and extended cert periods.Primary duties include, but are not limited to:&nbsp;ESSENTIAL FUNCTIONS:·Processes patient prior and reauthorization requests as outlined by company policy.·Makes determination of the need for continued home health care services by reviewing documentation submitted by providers in accordance with Medicare guidelines.·Refers to the Utilization Review Physician Advisor cases that do not meet established guidelines for admission or continued care.·Maintains accurate records of authorizations and communication with providers and payer plans pertaining to authorization for all patients.·Assists provider staff and team members in identifying patient needs and coordinating care.·Assists provider staff and team members in efficient and cost-effective utilization of health care resources and monitors patient progress and outcomes.·Facilitates communication and provides ongoing customer service support to payer plan case managers, patients and provider staff and team members.·Prepares and submits any required status or summary reports in a timely manner.·Periodic weekend and holiday rotation and availability to address after hour health plan member needs related to home health management.·Reviews documentation and provides feedback to clinicians regarding CMS Chapter 7 and Milliman Care Guidelines to ensure accurate assessment and review data, medical records reflect compliance with medical necessity, homebound status, visit utilization supported by individual patient assessment/ documentation support and transition (discharge) planning.·Identifies problems related to the quality of patient care and refers them to the Quality Assurance Committee/QPUC.·Assists the Utilization Review Committee/QPUC in the assessment and resolution of utilization review problems.·Other duties as required and/or assigned.OFFICE LOCATION:Fully RemoteQUALIFICATIONS·Is a graduate of an accredited school of professional nursing or an accredited practical or vocational nursing program.·Has at least two years of general nursing experience in medical, surgical, or critical care, and at least one year of utilization review/management, case management or recent field experience in home health.·Is currently licensed as a registered nurse, practical nurse, or vocational nurse in good standing through the Arizona Board of Nursing and other State Boards of Nursing as applicable.·Is detail oriented and displays good organizational skills as well as good oral and written communication skills.·Excellent time management skills with a proven ability to meet deadlines.·Is self-directed, flexible, cooperative, and exhibits the ability to work with minimal supervision.·Working knowledge of home care regulatory and federal requirements.KNOWLEDGE AND EXPERIENCE:Requires knowledge in the areas of home health community-based services; utilization/case management experience is preferred. Must have a working knowledge of homecare, managed care, medical/nursing staff procedures, and community resources. NCQA and URAC knowledge is helpful. Computer skills such as MS Office products - Outlook, Excel, Word, Adobe, and the ability to work within multiple electronic medical management systems.CONTINUING EDUCATION REQUIREMENTS:Company personnel are expected to participate in appropriate continuing education as may be requested and/or required by their immediate supervisor. In addition, company personnel are expected to accept personal responsibility for other educational activities to enhance job related skills and abilities. All company personnel must attend mandatory educational programs.tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.

tango

Utilization Review Nurse (Remote)

<h4>How you will change lives</h4>As a Patient Care Technician (PCT) at US Renal Care, you will be an integral part of a cross-functional team providing care and delegated activities of treatment to patients. The PCT will work under the supervision of a Registered Nurse (RN) or Charge Nurse (CN) for patients with renal failure.<h4>What you'll be doing</h4>Patient care. You will work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include gathering patient stats before and after treatment, initiating treatment, monitoring patients during treatment, terminating treatment, and collecting patient blood samples per physician orders.Technician Duties. You will ensure quality comes first by preparing machines for hemodialysis treatments, cleaning and disinfecting machines after treatment, and conducting machine safety checks and logging results for quality control, ensuring all protocols and regulations are followed.Safety and Quality. You will use appropriate safety measures, including personal protective equipment. Working under the supervision of a Charge Nurse, you will adhere to all company policies, procedures, and state/federal laws and regulations. You will participate in all required staff meetings and continuing education offerings.PATIENT CARE TECHNICIAN STATE SPECIFIC BOARD OF NURSING REQUIREMENTS California<ul><li>Must possess current Certified Hemodialysis Technician (CHT) certificate from California Department of Public Health (CDPH) at time of hire OR</li><li>Hired at USRC location recognized by state of California as an approved dialysis technician training program and obtain California state certification (CHT) within six (6) weeks of successful completion of training program. </li></ul>Maryland<ul><li>Must possess current Certified Nursing Assistants -- Dialysis Technicians (CNA-DT) certificate from Maryland Board of Nursing OR</li><li>Hired at USRC location recognized by state of Maryland as an approved dialysis technician training program and obtain Maryland CNA-DT certificate within three (3) months from date of hire OR</li><li>Out-of-state applicant must have active BONENT certification and provide proof of initial application for CNA-DT certification.</li></ul>New Mexico<ul><li>Must have New Mexico dialysis technician certificate at time of hire OR</li><li>Hired at USRC location recognized by state of New Mexico as an approved dialysis technician training program and obtain New Mexico state certification within six (6) months of successful completion of training program OR</li><li>New Mexico certification of hemodialysis technician is required for out of state applicant with active state or national hemodialysis certification; must obtain New Mexico state certification prior to working as a Certified Hemodialysis Technician. </li><li>After January 1st, 2024, all initial applications for the certified hemodialysis technician will require a national hemodialysis technician certificate.</li><li>The applicant must submit proof of a valid national hemodialysis technician certificate from a recognized organization.</li><li>Hemodialysis technician students must have a current basic life support credential prior to and while the student has contact with patients</li></ul>OHIO<ul><li>Must have Ohio dialysis technician intern certificate at time of hire OR</li><li>Hired at USRC location recognized by state of Ohio as an approved dialysis technician training program and submit application for Ohio dialysis technician intern certificate to board no later than four (4) weeks prior to completion of the approved training program.</li><li>Must obtain Ohio Board of Nursing Certificate (OCDT) not less than twelve (12) months and not later than eighteen (18) months of enrolling in the USRC OCDT program.</li></ul>OREGON<ul><li>Must possess current Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division at time of hire OR</li><li>Must obtain Oregon dialysis technician provisional certificate within three (3) weeks of successful completion of training program and obtain Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division within eighteen (18) months. An Oregon Provisional Certification is valid for six months and can be renewed for one additional six month period.</li></ul>&nbsp;

U.S. Renal Care

Dialysis Patient Care Technician

<h4>How you will change lives</h4>As a Patient Care Technician (PCT) at US Renal Care, you will be an integral part of a cross-functional team providing care and delegated activities of treatment to patients.&nbsp; The PCT will work under the supervision of a Registered Nurse (RN) or Charge Nurse (CN) for patients with renal failure.What you'll be doingPatient care. &nbsp;You will work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include gathering patient stats before and after treatment, initiating treatment, monitoring patients during treatment, terminating treatment, and collecting patient blood samples per physician orders.Technician Duties. &nbsp;You will ensure quality comes first by preparing machines for hemodialysis treatments, cleaning and disinfecting machines after treatment, and conducting machine safety checks and logging results for quality control, ensuring all protocols and regulations are followed.Safety and Quality. &nbsp;You will use appropriate safety measures, including personal protective equipment. Working under the supervision of a Charge Nurse, you will adhere to all company policies, procedures, and state/federal laws and regulations. You will participate in all required staff meetings and continuing education offerings. PATIENT CARE TECHNICIAN STATE SPECIFIC BOARD OF NURSING REQUIREMENTS California<ul><li>Must possess current Certified Hemodialysis Technician (CHT) certificate from California Department of Public Health (CDPH) at time of hire OR</li><li>Hired at USRC location recognized by state of California as an approved dialysis technician training program and obtain California state certification (CHT) within six (6) weeks of successful completion of training program. </li></ul>Maryland<ul><li>Must possess current Certified Nursing Assistants -- Dialysis Technicians (CNA-DT) certificate from Maryland Board of Nursing OR</li><li>Hired at USRC location recognized by state of Maryland as an approved dialysis technician training program and obtain Maryland CNA-DT certificate within three (3) months from date of hire OR</li><li>Out-of-state applicant must have active BONENT certification and provide proof of initial application for CNA-DT certification.</li></ul>New Mexico<ul><li>Must have New Mexico dialysis technician certificate at time of hire OR</li><li>Hired at USRC location recognized by state of New Mexico as an approved dialysis technician training program and obtain New Mexico state certification within six (6) months of successful completion of training program OR</li><li>New Mexico certification of hemodialysis technician is required for out of state applicant with active state or national hemodialysis certification; must obtain New Mexico state certification prior to working as a Certified Hemodialysis Technician. </li><li>After January 1st, 2024, all initial applications for the certified hemodialysis technician will require a national hemodialysis technician certificate.</li><li>The applicant must submit proof of a valid national hemodialysis technician certificate from a recognized organization.</li><li>Hemodialysis technician students must have a current basic life support credential prior to and while the student has contact with patients</li></ul>OHIO<ul><li>Must have Ohio dialysis technician intern certificate at time of hire OR</li><li>Hired at USRC location recognized by state of Ohio as an approved dialysis technician training program and submit application for Ohio dialysis technician intern certificate to board no later than four (4) weeks prior to completion of the approved training program.</li><li>Must obtain Ohio Board of Nursing Certificate (OCDT) not less than twelve (12) months and not later than eighteen (18) months of enrolling in the USRC OCDT program.</li></ul>OREGON<ul><li>Must possess current Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division at time of hire OR</li><li>Must obtain Oregon dialysis technician provisional certificate within three (3) weeks of successful completion of training program and obtain Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division within eighteen (18) months. An Oregon Provisional Certification is valid for six months and can be renewed for one additional six month period.</li></ul>&nbsp;

<h4>How you'll change lives</h4>As a Registered Nurse (RN) at US Renal Care, you'll be an integral part of a cross-functional team, working under the supervision of a Charge Nurse and assisting and supervising Patient Care Technicians (PCTs) to care for patients living with kidney disease.<h4>What you'll be doing</h4>Patient care. You'll work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include completing and documenting physical assessments before and after treatments and monitoring patients during treatment. You'll ensure quality renal care by completing monthly reviews of patient medication profiles and administering medications according to physician orders. Teamwork. You'll be a critical member of an interdisciplinary team to provide all required patient assessment and care planning activities. You'll also make sure center staffing requirements are met at all times under the direction of the Administrator and according to state regulations for staffing ratios.Safety &amp; Quality. Working under the supervision of a Charge Nurse, you'll adhere to all company policies and procedures and state and federal laws and regulations. You'll participate in all required staff meetings and continuing education offerings.

Dialysis Registered Nurse

SUMMARYThe Acute Registered Nurse provides acute dialysis care and treatment to patients within a hospital environment. This position performs duties as assigned by the Charge Nurse or Acute Manager, including assisting and supervising Patient Care Technicians and Licensed Vocational Nurses. Acute nurses may report directly to an Acute Manager, Administrator or the first line of regional operational management which may be an Area Director, Regional Director, or Vice President of Operations, depending on the region/demographics.Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.GROWTH· Assist with clinical and operational processes to improve patient health and minimize hospitalizations and rehospitalization.· Ensure patient and treatment charge information and other related data are accurate and submitted appropriately. · Demonstrate effective use of supplies and staff labor hours.· May participate in inventory management, including end-of-month inventory reporting and adherence to company purchasing protocols.· Perform duties as assigned to meet the patient care or operational needs.OUTCOMES· Administer medications as ordered by the physician..· Provide patient education and follow up as needed.· Assist with program's target goals in meeting quality metrics for patient outcomes in accordance with quality patient care and Company goals.OPERATIONALREADINESS· Knowledge of and comply with federal, state, local laws and regulations, including health care professionals practice act requirements.· Perform duties at all times within limitations established by and in accordance with company policy and procedures, hospital policy, applicable state and federal laws and regulations.· Complete water quality verification and equipment safety checks prior to each treatment, to include second verification as required.· Complete pre and post treatment physical assessments.· Complete pre and post Handoff Communication with hospital nurses.· Initiate and terminate patient treatments to include connecting and disconnecting catheters and cleaning catheter sites.· Set up dialysis machines; report machine problems to biomedical technician and/or Acute Manager as appropriate.· Clean, disinfect and provide quality control of dialysis machines as required by policy and procedures.· Participate in infection control monitoring, implementation, and recording as requested.· Use personal protective equipment as necessary.· Be familiar with emergency equipment and all emergency operational procedures, as required by hospital.OPERATIONALREADINESS (cont.)· Demonstrate effective staffing based on acuity, skill mix and company guidelines.· Ensure provision of dialysis related services such as Hemodialysis, Peritoneal dialysis, Continuous Renal Replacement Therapy (CRRT) and Plasmapheresis (TPE) if contracted to do so.· Participate in all surveys as required.· Ensure nursing care is carried out as directed and treatment is administered in accordance with physician orders.· Ensure appropriate and required information is documented in patient records.· Inform Supervisor, Medical Director or Physician and Hospital Liaison of all incidents, conditions, and concerns related to patient care, staff and patient safety, and in accordance with company policy.· Prepare and maintain dialysis machines and systems per policy: maintain dialysis records, prepare dialysis water treatment system for use according to established procedure and understand technical operations to troubleshoot problems independently.· Notify Bio-Medical Technician regarding machine or water treatment malfunctions, values out of parameters and document as required. PARTNERSHIPS· Communicate results of patient assessment, reassessment, and ongoing monitoring to the physician.· Maintain collaborative working relationship with physicians, nurse practitioners, and other hospital healthcare professionals.· Actively promote GUEST customer service standards; develop effective relationships at all levels of the organization.· Address patient concerns timely and professionally; following hospital policy.STAFF DEVELOPMENT/ RETENTION· Participate in staff meetings as required. Attend and complete all company and hospital required in-service and continuing education.· May delegate tasks to competent licensed and unlicensed staff per applicable state practice act.· Assist with staff training as requested.· Lead staff in team concepts and promote a team effort.

Dialysis Registered Nurse - St. Joseph Acutes

<h4>How you'll change lives</h4>As a Registered Nurse (RN) at US Renal Care, you'll be an integral part of a cross-functional team, working under the supervision of a Charge Nurse and assisting and supervising Patient Care Technicians (PCTs) to care for patients living with kidney disease.<h4>What you'll be doing</h4>Patient care. You'll work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include completing and documenting physical assessments before and after treatments and monitoring patients during treatment. You'll ensure quality renal care by completing monthly reviews of patient medication profiles and administering medications according to physician orders. Teamwork. You'll be a critical member of an interdisciplinary team to provide all required patient assessment and care planning activities. You'll also make sure center staffing requirements are met at all times under the direction of the Administrator and according to state regulations for staffing ratios.Safety &amp; Quality. Working under the supervision of a Charge Nurse, you'll adhere to all company policies and procedures and state and federal laws and regulations. You'll participate in all required staff meetings and continuing education offerings.

Dialysis Registered Nurse - PRN

Dialysis Registered Nurse - Dialysis experience

tango is a leader in the home care health management industry and is preparing for significant growth!&nbsp; We are seeking a hands-on Enterprise Architect with deep expertise in the US Healthcare ecosystem—specifically within home health and post-acute care.This individual will be instrumental in defining and driving the technical architecture and blueprint for our enterprise platforms.&nbsp; The ideal candidate will bring a strong mix of business acumen and technical depth, with proven experience in building and deploying applications in the Azure cloud environment.This role will collaborate closely with cross-functional departments including software engineering, product management, business stakeholders, data engineering, and infrastructure services.&nbsp; You’ll serve as a strategic partner in mapping out technical blueprints, optimizing data flows, making build vs. buy decisions, and ensuring interoperability across systems.RESPONSIBILITIES<ul><li>·Design and maintain enterprise architecture blueprints aligned to business goals and product strategies.</li><li>·Collaborate with product owners and business teams to understand core business processes and translate them into technical designs.</li><li>·Map data flows across systems including operational platforms, data lakes/warehouses, and external partners.</li><li>·Drive architectural decisions around interoperability standards including FHIR, HL7, and EDI X12 transactions (e.g., 837i, 278).</li><li>·Guide build vs. buy decisions with a long-term platform strategy in mind. Work hands-on to prototype, evaluate, and deliver proof-of-concept technical solutions to software engineering teams in a cloud-native manner.</li><li>·Other duties as assigned.</li></ul>QUALIFICATIONS&nbsp;<ul><li>·US Citizenship is required due to access to sensitive healthcare data.</li><li>·10+ years in software architecture, with a strong focus on US Healthcare, particularly home health and post-acute care.</li><li>·Experience working with health systems and payers.</li><li>·Deep understanding of interoperability protocols and standards: FHIR, HL7, EDI X12 (e.g., 837i, 278) and healthcare compliance frameworks (e.g., HIPAA)..</li><li>·Demonstrated success architecting and deploying solutions in Microsoft Azure.</li><li>·Hands-on experience working with data engineering teams and understanding of data flow across complex systems.</li><li>·Strong background in agile development environments and leading engineering teams.</li><li>·Familiarity with Microsoft Cloud for Healthcare is a strong plus.</li><li>·Experience integrating with EHRs, EMRs, and payer systems is a plus.</li><li>·Prior experience with SaaS and product development lifecycle.</li><li>·Detailed oriented person with excellent written and oral communication skills.</li><li>·Must demonstrate ability to handle diversity amongst people and environments.</li><li>·Must be detail oriented and able to follow-up and follow-through on project actions and tasks.</li><li>·Ability to maintain confidentiality of sensitive information.</li></ul>JOB TYPE: Full-timeLOCATION: Remote, USAtango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship

14 Healthcare Jobs in Arizona