About this role
High-Cost Claimant Review Unit Nurse Auditor at Blue Cross Blue Shield of Arizona. Location: Phoenix or Tucson or Chandler or Flagstaff. Role: reviewing claims, analyzing utilization, coordinating care Requirements: Active Arizona RN license, 5+ years healthcare experience with at least 2 years as an RN analyst/auditor in utilization review/medical claim review or care management; associate degree in nursing required; experience with VITAL/Metavance/Guiding Care and data/operational analysis. Category: Healthcare Services - Nursing Seniority: Senior Level Tools: VITAL, Metavance, Guiding Care Certifications: rn, case manager, pmp, cphq, six sigma Commitment: Full Time Workplace: Remote Languages: English