- Premera Blue Cross (Mountlake Terrace, WA)
- …contractual, and legal requirements. **What you will bring** **:** **Required:** **?** + Registered Nurse - RN current state licensethat allows the professional ... target members (those who are facing medical, mental health and/or substance utilization disorders) and build a relationship that will support open and constructive… more
- Cognizant (Olympia, WA)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Olympia, WA)
- …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- CVS Health (Olympia, WA)
- …Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization . **Required Qualifications** + Registered Nurse (RN) ... CVS Health Aetna has an opportunity for a full-time Utilization Management (UM) Nurse Consultant. As a...Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills… more
- Humana (Olympia, WA)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- CVS Health (Olympia, WA)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Molina Healthcare (Bellevue, WA)
- …+ Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team ... The Clinical Services Auditor performs auditing of clinical staff in Utilization Management (UM), Case...them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN) Program and Associate's or… more
- Veterans Affairs, Veterans Health Administration (Spokane, WA)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... all healthcare disciplines included on the HBPC teams. Responsible for directing the clinical and administrative services offered by the program to ensure that the… more
- CVS Health (Olympia, WA)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Veterans Affairs, Veterans Health Administration (Spokane, WA)
- …more information, refer to Required Documents below. Responsibilities The Critical Care Registered Nurse (RN) is responsible and accountable for individual ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… more
- Humana (Olympia, WA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- CVS Health (Olympia, WA)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization… more
- Virginia Mason Franciscan Health (Kirkland, WA)
- …**Job Requirements** Required: + This position requires current licensure as a registered nurse plus one years' increasingly responsible health careoperations ... you will be responsible for the daily operations and clinical oversight of the clinic. You will lead and...clinic. You will lead and mentor a team of registered nurses and support staff, ensuring the delivery of… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …to do meaningful work. **Job Requirements** + Current, valid RN licensure as a registered nurse in the State of Washington required. + CPR certification is ... to the nursing staff to ensure optimal flow and utilization of resources to meet demand for services with...or as specified by the work. + Four years clinical experience in a long-term care/nursing home or acute… more
- Fresenius Medical Center (Spokane, WA)
- **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN, for a limited period of time, and ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
- Evolent (Olympia, WA)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- Swedish Health Services (Seattle, WA)
- **Description** The Assistant Nurse Manager (ANM) is a professional Registered Nurse reporting to the unit director/manager who utilizes the nursing process ... to manage clinical and operational activities within assigned shift. The ANM...be a condition of employment. + Upon hire: Washington Registered Nurse License. + Upon hire: National… more
- Molina Healthcare (Vancouver, WA)
- …and/or coding experience, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities....or modification of payment decisions. * Serves as a clinical resource for utilization management, chief medical… more
- General Dynamics Information Technology (Lakewood, WA)
- … Credentialing Center. + Current RN license; full, active, and unrestricted license as a Registered Nurse in one of any US State, the District of Columbia, Guam, ... Seize your opportunity to make a personal impact as Nurse Case Manager supporting mission critical work on an...of professional health nursing principles, practices, and procedures in clinical settings to analyze the full scope of problems… more
- Sharecare (Olympia, WA)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
