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Registered Nurse Intake
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Posted on: Nov 10, 2026
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Phoenix, Arizona
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Salary: $40 per hour
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Remote
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Full-time
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Job Title :
Registered Nurse Intake
Job Type :
Full-Time
Job Location :
Phoenix Arizona United States
Remote :
Yes
Job Description :
Location: Phoenix, AZ, 85003
Duration: 6 Months
Job Type: Temporary Assignment
Work Type: Remote
- Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards.
- Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal.
- Ensures timely review, processing, and response to appeals in accordance with State, Federal and NCQA standards.
- Communicates with members, providers, facilities, and other departments regarding appeals requests.
- Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards.
- Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeals requests.
- Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices.
- Performs other duties as assigned.
- Complies with all policies and standards.
- Requires a degree from an Accredited School of Nursing or Master's degree in Behavioral Health or Social Work and 2 4 years of related experience.
- Knowledge of NCQA, Medicare and Medicaid regulations preferred.
- Knowledge of utilization management processes preferred.
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required, or
- LCSW - Licensed Clinical Social Worker required, or
- LMHC - Licensed Mental Health Counselor required, or
- LPC - Licensed Professional Counselor required, or
- Licensed Marriage and Family Therapist (LMFT) required, or
- Licensed Psychologist required.
- RN license required.
- 2 4 Years of Experience
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Position Details
Posted:
Nov 10, 2026
Reference Number:
52559-12690
Employment:
Full-time
Salary:
$40 per hour
City:
Phoenix
Job Origin:
CIEPAL_ORGANIC_FEED
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