Blue Cross Blue Shield of Arizona - Remote work

Seeking a skilled **BH Clinical Reviewer** for a remote role based in **Phoenix, AZ**. You will handle **utilization management**, analyze medical records, and apply medical necessity criteria. Requires an active AZ license (LCSW, LPC, LMFT, RN, or Psy.D.) with 2+ years of clinical or health insu...

Seeking an experienced **Integrated Care Manager** for a **Medicare Advantage** health plan. This remote role requires a current RN or behavioral health license (LCSW, LMFT, etc.) valid in Arizona. You will assess member needs, coordinate care plans, and manage high-volume calls regarding benefit...

Seeking a detail-oriented **Registered Nurse** for an **Initial Clinical Reviewer** role in **Phoenix, AZ**. You will analyze medical records, apply necessity criteria, and resolve health insurance inquiries. Requires an active RN/LPN license, an Associate’s degree or Nursing Diploma, and 2+ year...

Seeking an experienced **Health Plan Pharmacist** in **Phoenix, AZ** to manage Medicare/Medicaid formularies. Requires a Pharm.D, 5+ years of practice, and 3 years in managed care with prior authorization expertise. You will provide clinical data, conduct audits, and educate staff. Enjoy a role w...

Remote Business Intelligence Developer role focused on Medicaid analytics. Leverage T-SQL, SSRS, and Power BI to design sustainable reporting solutions and drive data-driven decisions. Requires 2 years of data analysis experience and intermediate SQL Server skills. Join a collaborative team in Ph...

Seeking a Clinical Trainer and Auditor in Phoenix, AZ, for a remote/hybrid role. You will develop clinical curriculum, deliver training, and conduct quality audits to ensure standardization. Requires an RN or MSW license in Arizona with 5+ years of clinical care and 4 years of clinical education ...

Seeking an **Initial Clinical Reviewer** for a remote role based in Arizona. You will handle health insurance inquiries, analyze medical records, and apply medical necessity criteria. Requires an active AZ license (LCSW, LPC, RN, LPN) and 2+ years of clinical or health insurance experience. Join ...