- Battelle Memorial Institute (Tacoma, WA)
- …as a case manager by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing Center + At least two ... Research and Analytics (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support of our government customer,… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …regulatory requirements, and ensures these requirements are accurately followed and Utilization Management (UM) decision determinations and timeliness standards ... experience (REQUIRED) + Current State Licensure as a registered nurse (REQUIRED) + Three (3) years of clinical experience...+ Three (3) years of clinical experience (REQUIRED) + Utilization Management experience + Experience working in… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …regulatory requirements, and ensures these requirements are accurately followed and Utilization Management (UM) decision determinations and timeliness standards ... law **(Required)** + Three (3) years of clinical experience ( **Required)** + Utilization Management experience (Preferred) + Experience working in the health… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Blue Cross, a nationally recognized leader in the practice of integrated case management , is looking to expand our growing team of Case Managers.? Our comprehensive, ... lead to self-care. In the interim, case managers employ an integrated case management approach that recognizes making lifestyle changes is not simple and meets… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Olympia, WA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse within the Clinical Access Grievance Team utilizes ... care management and utilization management skills...are available as needed. The Clinical Access Grievance Team Nurse uses clinical knowledge, communication skills, and independent critical… more
- Humana (Olympia, WA)
- …Work hours will be an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication, and independent critical ... Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary...a team **Preferred Qualifications** + BSN + Knowledge of Utilization Management + Previous Medicare and Medicaid… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Olympia, WA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Olympia, WA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
- CVS Health (Olympia, WA)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Swedish Health Services (Seattle, WA)
- …strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. ... education and training for staff and other health care providers regarding utilization management process, including but not limited to: reimbursement patterns,… more
- Providence (Olympia, WA)
- …a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. ... + Bachelor's Degree Or Associate's Degree in Nursing + 3 years of Utilization Review, Care Management , Quality Management , and/or Discharge planning… more
- Veterans Affairs, Veterans Health Administration (Spokane, WA)
- Summary The Registered Nurse (Integrated Care Management ) within the Office of Integrated Veteran Care (IVC) functions as an advisor, administrator, educator, ... outcomes for Veteran healthcare Providing guidance and oversight of national program management to ensure proper resource utilization . Providing the Veteran's… more
- Sharecare (Olympia, WA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Molina Healthcare (Everett, WA)
- …and cost-effective member care. **Job Duties** + Performs Behavioral Health utilization management reviews for inpatient, outpatient, and intermediate-level ... and/or Nurse Practitioner, ideally in managed care, behavioral health, or utilization management . + Demonstrated experience in the application of medical… more
- Veterans Affairs, Veterans Health Administration (Tacoma, WA)
- …the following core informatics functions to include content management , application support, health information technology system optimization, enterprise ... data management , business architecture management , partnership management...education, orientation, competencies and providing quality improvement and outcomes utilization . VA offers a comprehensive total rewards package: VA… more
