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RN Staff Nurse
Company : Catholic Health Initiatives
Location : Gold Canyon, AZ, 85118
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
In Gold Canyon, AZ, certifications like Certified Case Manager (CCM) or Accredited Case Manager (ACM-RN) boost RN Staff Nurse credentials, especially for those involved in utilization review and patient care coordination. Employers also value active AZ or compact nursing licenses and utilization review training.
RN Staff Nurses uniquely blend clinical expertise with utilization review responsibilities, ensuring hospital stays meet stringent criteria. Unlike typical bedside roles, they assess admissions, collaborate with physicians, and navigate payer regulations, making their role pivotal for optimizing care and compliance.
Expect to conduct admission and continued stay reviews, communicate with care teams and payers, and address patient status order issues. The role demands critical thinking to uphold quality care standards while aligning with Catholic Health Initiatives’ mission of compassionate, efficient healthcare delivery.
Yes, working at St. Joseph's involves managing complex cases from diverse patient populations, requiring precise utilization review and collaboration with specialized teams. Navigating high patient acuity and regulatory compliance in a quaternary care setting adds layers of responsibility and rewards.
Gold Canyon's proximity to Phoenix offers access to a high-demand nursing market. While Phoenix has more positions due to larger healthcare facilities, competition is stiff because of the area's reputation for quality hospitals. Candidates with advanced certifications and utilization review experience stand out.
RN Staff Nurses in Gold Canyon typically earn between $65,000 and $85,000 annually, reflecting the region’s cost of living and demand for clinical expertise in acute settings. Specialized skills in utilization review and certifications often push compensation toward the upper range.
Catholic Health Initiatives fosters continuous learning through access to advanced training, inter-rater reliability testing, and support for certification like CCM. The organization emphasizes humankindness and career development, encouraging nurses to expand their clinical and case management expertise.
At Catholic Health Initiatives, the RN Staff Nurse role integrates clinical acuity with a strong focus on utilization review and care coordination in a faith-driven environment. The blend of high-complexity patient care and commitment to underserved populations sets it apart.
An active Arizona RN license or a compact license is essential. Additionally, familiarity with CMS, AHCCCS, and payer-specific criteria is highly valued locally, considering state regulations and the complex insurance landscape in Gold Canyon and the Phoenix metro area.
Many assume RN Staff Nurses solely provide bedside care, but in acute settings like St. Joseph’s, they also handle utilization reviews, collaborate extensively with physicians, and ensure regulatory compliance. Their role is both clinical and administrative, requiring multifaceted skills.