Risevoic
Outpatient RN
Company : Catholic Health Initiatives
Location : Glendale, AZ, 85302
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 Glendale, AZ, certifications like Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), and Utilization Management credentials significantly boost an outpatient RN's qualifications, enhancing trust with local healthcare providers and payers familiar with state and federal care standards.
Outpatient RNs focus on utilization review, care coordination, and ensuring efficient resource use, contrasting with inpatient RNs who provide direct bedside care. This role requires critical evaluation of admissions and stays, emphasizing regulatory compliance and interdepartmental communication to optimize outpatient services.
Phoenix’s diverse patient base and high influx of out-of-state cases create a dynamic outpatient environment. Nurses must adeptly navigate complex insurance regulations like CMS and AHCCCS, address multicultural communication needs, and manage care coordination across multiple facilities.
Catholic Health Initiatives offers outpatient RNs pathways into case management, utilization review leadership, or specialized clinical coordination roles, supported by ongoing education and alignment with respected institutions like St. Joseph’s Hospital, fostering professional growth within Arizona’s healthcare landscape.
Glendale shows robust demand for outpatient RNs due to expanding healthcare services, but competition remains moderate compared to Phoenix downtown. Candidates with certifications and utilization review experience stand out, particularly with knowledge of local payer protocols and hospital affiliations.
Catholic Health Initiatives emphasizes a mission-driven culture focused on underserved populations, with outpatient RNs engaging in comprehensive utilization review and collaboration with leading centers like St. Joseph’s. This fosters a unique blend of clinical rigor and community-centered care.
Yes, Catholic Health Initiatives encourages outpatient RNs to enhance credentials such as CCM or ACM-RN through tuition assistance and professional development programs, reinforcing their commitment to high-quality, compliant care within Arizona’s regulatory framework.
Outpatient RNs in Glendale typically earn between $65,000 and $85,000 annually, reflecting local market conditions and specialized skills in utilization review and case management. Certified nurses or those with extensive experience may command salaries at the higher end of this spectrum.
Absolutely, outpatient RNs routinely work alongside physicians, care coordinators, insurance specialists, and post-acute providers to optimize patient outcomes, ensuring a cohesive approach to utilization review and care management within Catholic Health Initiatives.
Yes, Glendale’s outpatient clinics, including those affiliated with Catholic Health Initiatives, offer pediatric outpatient RN roles requiring specialized skills in child patient communication and care coordination, addressing unique age-specific clinical and regulatory considerations.