Risevoic
RN Nurse
Company : Catholic Health Initiatives
Location : Chandler, AZ, 85249
Job Type : Full Time / Part Time
Date Posted : 23 December 2025
Job Summary and Responsibilities
Under the general direction of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use of resources; promote quality patient care; assist with patient care management; comply with applicable standards and regulations and provide information and education to clinical care providers in order to achieve optimal clinical, financial, operational and patient satisfaction outcomes.
Skills needed:
Knowledge of federal, state and managed care rules and regulations including CMS and AHCCCS. Working knowledge with INTERQUAL or Milliman preferred. Excellent written and verbal communication skills with the ability to interact with patients/family, clinical staff, insurance providers and post-acute care providers.
Responsibilities:
- Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on established criteria and critical thinking. Reviews include admission, concurrent and post discharge for appropriate status determination.
- Ensures compliance with principles of utilization review, hospital policies and external regulatory agencies, Peer Review Organization (PRO), Joint Commission, and payer defined criteria for eligibility.
- Reviews the records for the presence of accurate patient status orders and addresses deficiencies with providers.
- Ensures timely communication and follow up with physicians, payers, Care Coordinators and other stakeholders regarding review outcomes.
- Collaborates with facility RN Care Coordinators to ensure progression of care.
- Engages the second level physician reviewer, internal or external, as indicated to support the appropriate status.
Minimum:
- Graduate of an accredited school of nursing
- Minimum two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience
- RN: AZ or Compact License
- Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used
Preferred:
- Bachelor's Degree in Nursing (BSN) or related healthcare field
- At least five (5) years of nursing experience
- Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification
- Utilization Review experience
Hello humankindness
Located conveniently in the heart of Phoenix, Arizona, St. Joseph's Hospital and Medical Center is a 571-bed, not-for-profit hospital that provides a wide range of health, social and support services. Founded in 1895 by the Sisters of Mercy, St. Joseph's was the first hospital in the Phoenix area. More than 125 years later, St. Joseph's remains dedicated to its mission of caring for the poor and underserved.
We are extremely proud to be a nationally recognized center for quality quaternary care, medical education and research. St. Joseph's includes the internationally renowned Barrow Neurological Institute, Norton Thoracic Institute, Cancer Center at St. Joseph's, Ivy Brain Tumor Center, and St. Joseph's Level I Trauma Center (which is verified by the American College of Surgeons). The hospital is also a respected center for high-risk obstetrics, neuro-rehabilitation, orthopedics, and other medical services. St. Joseph’s is considered a sought-after destination hospital for treating the most complex cases from throughout the world. Every day, approximately 20 percent of the hospital’s patients have traveled from outside of Arizona and the United States to seek treatment at St. Joseph’s.
U.S News & World Report routinely ranks St. Joseph's among the top hospitals in the United States for neurology and neurosurgery. In addition, St. Joseph's boasts the Creighton University School of Medicine at St. Joseph's, and a strategic alliance with Phoenix Children's Hospital.
St. Joseph's is consistently named an outstanding place to work and one of Arizona's healthiest employers. Come grow your career with one of Arizona's Most Admired Companies
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For the health of our community ... we are proud to be a tobacco-free campus.
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Frequently asked questions
RN Nurses in Chandler, AZ, especially within Catholic Health Initiatives, uniquely blend clinical expertise with utilization review processes. This integration ensures hospital stays meet strict criteria, optimizing both patient outcomes and resource use. Familiarity with CMS, AHCCCS rules, and tools like InterQual enhances this critical balance.
Certifications such as Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or Utilization Management credentials significantly elevate an RN Nurse's qualifications in Phoenix's competitive healthcare market. These endorsements demonstrate expertise in patient care coordination, compliance, and utilization review—key for roles at facilities like St. Joseph’s Hospital.
Employers in Chandler value RN Nurses with strong communication abilities to liaise effectively with patients, families, and interdisciplinary teams. Knowledge of federal and state healthcare regulations and experience with utilization review software like Milliman or InterQual also set candidates apart in this market.
At Catholic Health Initiatives, RN Nurses not only provide bedside care but also perform critical utilization reviews and collaborate on care management strategies. This dual focus on clinical and operational outcomes distinguishes the role from more traditional hospital RN positions centered solely on direct patient care.
Catholic Health Initiatives supports RN Nurses with pathways into advanced case management, utilization review leadership, and specialized certifications. Working at a nationally recognized center like St. Joseph’s Hospital also opens doors to roles in quaternary care and collaborative research environments.
Chandler, AZ’s expanding healthcare sector creates steady demand for skilled RN Nurses, especially those versed in utilization review. While opportunities are abundant, competition grows for positions at top facilities like Catholic Health Initiatives, making certifications and acute care experience valuable differentiators.
RN Nurses in Chandler typically earn between $65,000 and $85,000 annually, depending on experience and certifications. Roles involving utilization review and case management, such as at Catholic Health Initiatives, may command salaries on the higher end due to specialized skill requirements.
St. Joseph’s commitment to serving underserved populations shapes RN Nurses' responsibilities by emphasizing compassionate care paired with rigorous utilization review. Nurses support complex cases while adhering to ethical standards, ensuring quality treatment aligned with the hospital's long-standing community focus.
This RN Nurse position uniquely combines clinical nursing with in-depth utilization review, requiring comprehensive knowledge of federal and state healthcare regulations like CMS and AHCCCS. It's ideal for nurses aiming to impact both patient care quality and regulatory adherence in a hospital setting.
Chandler offers relatively manageable commutes with well-connected roadways, which benefits RN Nurses seeking positions at Catholic Health Initiatives or nearby hospitals. However, peak hours can increase travel time, so proximity and flexible scheduling are important factors for local candidates.