Risevoic
Staff Registered Nurse
Company : Catholic Health Initiatives
Location : Mesa, AZ, 85206
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 Mesa, AZ, certifications like Certified Case Manager (CCM) or Accreditation in Utilization Management can significantly boost a Staff Registered Nurse’s credibility. These credentials align with local healthcare standards and payer requirements, making candidates more competitive in a market that values compliance and quality patient care.
Mesa shows a steady need for Staff Registered Nurses due to its growing patient population and multiple health centers like St. Joseph’s. Compared to larger cities like Phoenix, Mesa offers a balanced job market with slightly less competition but still robust opportunities in acute and specialty care.
Beyond bedside nursing, Staff Registered Nurses must excel in utilization review, effective communication with multidisciplinary teams, and regulatory compliance. These skills ensure hospital stays are medically justified and efficient, which is vital for optimizing healthcare resources and patient outcomes.
Unlike general RNs focused primarily on direct patient care, Staff Registered Nurses often handle complex tasks such as utilization review, coordination with insurance providers, and compliance monitoring. This role blends clinical expertise with administrative oversight to improve care quality and cost-effectiveness.
Staff Registered Nurses can advance into case management leadership, clinical education, or specialized utilization review roles. Additional certifications and experience with healthcare regulations enhance opportunities for managerial positions or consulting within healthcare systems.
Catholic Health Initiatives supports Staff Registered Nurses with access to top-tier quaternary care environments, ongoing education, and a mission-driven culture. Nurses benefit from working alongside renowned institutes like Barrow Neurological and participate in innovative patient care models.
At Catholic Health Initiatives, Staff Registered Nurses collaborate closely with physicians, care coordinators, and payers to ensure adherence to utilization criteria. This integration fosters comprehensive care management, facilitating smoother patient transitions and optimized resource use.
Staff Registered Nurses in Mesa generally earn between $70,000 and $90,000 annually, reflecting experience, certifications, and hospital complexity. Compensation at facilities like St. Joseph’s also factors in the specialized skills in utilization review and case management.
A frequent misconception is equating Staff Registered Nurses solely with bedside care. In reality, this role demands proficiency in utilization review, regulatory adherence, and complex coordination tasks that go beyond typical staff nurse duties in clinics or offices.
Managing timely communication among physicians, payers, and care teams in a high-acuity center can be challenging. Staff Registered Nurses must navigate regulatory criteria and ensure documentation accuracy while balancing patient flow and resource constraints.