- Healthfirst (WA)
- … management, identifying alternative care options, and discharge planning** + **Certified Case Manager ** + **Interqual and//or Milliman knowledge** + **Knowledge ... This position is 100% Remote** **Duties//Responsibilities:** + **Provides case management services for assigned member caseloads which includes:** +… more
- Molina Healthcare (Everett, WA)
- …medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist, UM will be responsible for reviewing coverage determinations and ... in a timely, compliant, and accurate manner. The Pharmacist, UM will also be responsible for serving as a...changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary… more
- Elevance Health (Seattle, WA)
- …thinking skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate equipment, ... about plan benefits and physicians and may assist with case management. + Collaborates with leadership in enhancing training...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Humana (Olympia, WA)
- …a part of our caring community and help us put health first** The Telephonic Nurse Case Manager will be a member of the In-Home Case Management Team, ... case management throughout the continuum of care. The case manager will offer guidance, support, and...Management programs (DM/PN) as needed, in addition to MTF UM / CM staff, physicians and providers as necessary;… more
- Whidbey General Hospital (Coupeville, WA)
- …+ Washington State DOH RN License required. + Current BLS HCP required. + Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. ... home health, Hospice, skilled nursing, anti-biotic regime, etc. The RN - Care Manager follows the hospital's Case Management/Utilization Plan that integrates the… more
- Highmark Health (Olympia, WA)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- Molina Healthcare (Bellevue, WA)
- …Clinical Services Auditor performs auditing of clinical staff in Utilization Management ( UM ), Case Management (CM), Member Assessment Team (MAT), Health ... auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case Management (CM), Member Assessment Team (MAT), Health Management… more
- Highmark Health (Olympia, WA)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
- Sharecare (Olympia, WA)
- …days of training. PTO needs during the training period will be evaluated on a case by case basis and must be approved in advance._ **Compensation:** $22.00/hour ... hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management ( UM ) status, including but not limited to medical, dental, and vision… more