- Premera Blue Cross (Mountlake Terrace, WA)
- …knowledge of different claim types is desired. (Preferred) + Current Washington State License: Registered Nurse ( RN ), Advanced Registered Nurse ... appropriate procedure and diagnosis codes, and support business decisions regarding utilization management activities and guidelines. + Support medical policy… more
- Battelle Memorial Institute (Tacoma, WA)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... as a case manager by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing Center + At least… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Please note this position aligns to PST business hours.** The **Manager, Case Management ** Team is a Supervisor for Case Managers. This position is responsible for ... of professional paraprofessional, and administrative team members. + Lead Care Management teams in effective performance of job functions, which may include… more
- Parexel (Olympia, WA)
- **Job Title:** Data Management Lead (Medical Affairs) - Oncology **Location:** Fully Remote (US based) Must be able to accommodate West Coast hours. **About Us:** At ... solutions. We are seeking a dynamic and experienced Data Management Lead to join our team. If you have...practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …or Compact License in one of the following: + Nursing: Current registration as a nurse (eg, RN , ARNP) + Behavioral Health: Valid licensure (eg, LMFT, LICSW, ... nationally recognized leader in the practice of integrated case management , is looking to expand our growing team of...(those who are facing medical, mental health and/or substance utilization disorders) and build a relationship that will support… 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...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- CVS Health (Olympia, WA)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CenterWell (Olympia, WA)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… 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. ... must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of...Or Associate's Degree in Nursing + 3 years of Utilization Review, Care Management , Quality Management… more
- Pacific Medical Centers (Renton, WA)
- …Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family Health ... USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly...be RN ) And + Upon hire: Washington Registered Nurse License + 5 years Clinical… more
- Providence (Olympia, WA)
- …admissions. + **Physician Relations:** Build strong cooperative relationships with physicians. + ** Utilization Management Oversight:** Lead the Utilization ... supervision of the North Division Executive Director of Care Management , the Director of Care Management is...+ **Clinical Experience:** At least 2 years as an RN in an acute care setting. + **Leadership Experience:**… more
- CVS Health (Olympia, WA)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating… more
- Molina Healthcare (Bellevue, WA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more
- Elevance Health (WA)
- …services in multiple states. **Preferred Skills, Capabilities and Experiences:** + Utilization Management and/ore Case Management experience strongly ... **Medical Management Clinician Associate** Carelon Post Acute Solutions A...a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted… more
- Providence (Olympia, WA)
- **Description** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient centric care management services for at ... Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation… more
- Providence (Spokane, WA)
- **Description** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient centric care management services for at ... Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …experience. **Licensure and Certifications:** Required + Current licensure as a Registered Nurse in the state of Washington ( RN -WA). + BLS required within 3 ... emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post… more
- Molina Healthcare (Tacoma, WA)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports… 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, ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
