- Elevance Health (Seattle, WA)
- …providers. **How you will make an impact:** + Conducts investigations and reviews of member and provider medical necessity appeals . + Reviews prospective, ... either uphold or deny appeal and forwards to Medical Director for approval. + Ensures that appeals ...or any combination of education and experience, which would provide an equivalent background. Current active unrestricted RN license… more
- Pacific Medical Centers (Seattle, WA)
- **Description** **Overview:** The director provides leadership for USFHP clinical operations: including care management and the clinical quality management program. ... In collaboration with the Executive Director , develops and implements policies and procedures, staff training materials, and process protocols. Oversight for… more
- Providence (Seattle, WA)
- **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote. The role requires a broad knowledge and focus on ... the quality and cost effectives of healthcare delivery. Responsible to provide oversight and comprehensive strategic alignment, design, optimization, and improvement… more
- Elevance Health (Seattle, WA)
- …clinical guidelines and/or serve as a subject matter expert. + Perform first level provider appeals as designated by the client for adverse determinations. + ... **Clinical Operations Medical Director ** **Utilization Management of Medical Oncology Benefits** **Carelon...the opportunity to work remotely from home. _A proud member of the Elevance Health family of companies, Carelon… more
- University of Washington (Seattle, WA)
- …and content related to digital communications (newsletters, notifications, appeals , event invitations/reminders/follow-ups, event registration sites, etc.). * Lead ... creative strategy, timelines, and success metrics. * Support the Assistant Director , Digital Production by soliciting early project requests from departments and… more