- Seattle Children's (Seattle, WA)
- …Research Institute. Lead, implement, and provide personnel management, fiscal analysis, review and reporting, compliance with appropriate regulations, and grant pre- ... License. **Preferred** Master's degree in Nursing or Advanced Registered Nurse Practitioner. Database management skills. Supervisory experience/skills. Past or… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …. The **Care Coordinator - Retrospective** performs prospective review (benefit advisory/ prior authorization) admission, concurrent, and retrospective ... **Pacific Time** **What you'll do:** + Performs medical necessity review that includes inpatient review , concurrent ...experience (REQUIRED) + Current State Licensure as a registered nurse (REQUIRED) + Three (3) years of clinical experience… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …about once every quarter.** **What you will do:** + Performs medical necessity review that includes inpatient review , concurrent review , benefits ... (4) years' work experience **(Required)** + Current State Licensure as a registered nurse where licensing is required by State law **(Required)** + Three (3) years… more
- Molina Healthcare (Everett, WA)
- …on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for medical claim and internal ... appeals review activities - ensuring alignment with applicable state and...equivalent combination of relevant education and experience. + Registered Nurse (RN). License must be active and unrestricted in… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- …complete review of the EDRP application. Responsibilities Licensed Practical Nurse (LPN) demonstrates knowledge and ability to provide practical nursing care to ... physical, emotional and chronological maturation. Maintains appropriate boundaries in the nurse / Veteran relationship by not obtaining personal gain at Veterans'… more
- EvergreenHealth Monroe (Monroe, WA)
- …semi-rural acute care hospital has a fantastic opportunity for an experienced REGISTERED NURSE to fill a position in our Emergency Department Unit. Working together, ... objectives, policies, and procedures of the hospital and the Washington State Nurse Practice Act. Demonstrates knowledge and skills required to respond rapidly to… more
- Chenega Corporation (Seattle, WA)
- **Summary** **CHENEGA TRI-SERVICES, LLC.** Seattle, WA. The ** Nurse Practitioner** shall perform medical histories, physical examinations, and reviews of required ... medical histories on applicants for the Armed Forces + Review of required medical tests and documents pertaining to...from a program accredited by the American Academy of Nurse Practitioners Certificate Program (ANPCP) or the American Nurses… more
- Sunrise Senior Living (Bellevue, WA)
- …NAME** Sunrise of Bellevue **Job ID** 2025-228848 **JOB OVERVIEW** The Wellness Nurse is responsible for monitoring the health and well-being of our residents ... Resident Assessment/Evaluation process in accordance with state/provincial regulatory requirements + Review Physician Reports of all new residents as directed by… more
- Molina Healthcare (Everett, WA)
- …Supports process improvement initiatives and contributes to the development of clinical review guidelines and training materials. + Works under the medical direction ... an accredited program. + Completion of a Psychiatric-Mental Health Nurse Practitioner program at the master's level with current...+ Minimum 3 years of experience as a Registered Nurse and/or Nurse Practitioner, ideally in managed… more
- Elevance Health (Seattle, WA)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Surgery Care Affiliates (Poulsbo, WA)
- …you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse (RN) PreOp PACU. + Promote the mission, vision, and values of SCA . + ... to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing...with other disciplines as needed. + Participate in quality review and performance improvement projects. + Participate in the… more
- University of Washington (Seattle, WA)
- …Care, Perinatal, Perioperative, Emergency Department, or outpatient or procedural areas, please review the postings on the website and apply to those positions when ... specific requirements + BLS required + Active license to practice as a registered nurse in the State of Washington required by start date **ABOUT UW MEDICAL… more
- The Cigna Group (Seattle, WA)
- …proposition. + Supports achievement of business growth targets including prospective review , request for proposal, finalist meeting and newclient onboarding. + ... persistence targets includingmedicalcost driver analysis and action, complex case review , referral and engagement, account renewal consultation and recommendations… more
- Swedish Health Services (Seattle, WA)
- …you the chance to focus on what really matters - our patients.** The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed ... **Description** **Utilization Review RN @ Swedish Medical Center** **Part time...reimbursement requirements of commercial and government payers. The UR nurse is responsible for performing admission, concurrent and retrospective… more
- Molina Healthcare (Everett, WA)
- For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for our Ohio ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Everett, WA)
- For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high ... on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member… more
- Molina Healthcare (Everett, WA)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying ... unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours: Monday - Friday...equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- Molina Healthcare (Everett, WA)
- JOB DESCRIPTION Job Summary The Care Review Clinician RN provides support for clinical member services review assessment processes. Responsible for verifying ... Candidates with MCO experience are highly preferred. The Care Review Clinician must be able to work independently in...equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- Molina Healthcare (Everett, WA)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant education… more
- Molina Healthcare (Everett, WA)
- JOB DESCRIPTION Job Summary The Care Review Clinician (RN) provides support for clinical member services review assessment processes. Responsible for verifying ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant education… more
