- Molina Healthcare (Bellevue, WA)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
- Molina Healthcare (Bellevue, WA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (Bellevue, WA)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- CenterWell (Kent, WA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Virginia Mason Franciscan Health (Gig Harbor, WA)
- …2) developing/overseeing a regional length-of-stay multi-disciplinary team (eg care management, utilization review , finance, etc.); and 3) working with ... improvements. + Collaborates with a multi-disciplinary team (eg care management, utilization review , finance/patient access, etc.) to address patient flow/bed… more
- Providence (Everett, WA)
- …and development. Apply now and be a part of something extraordinary!The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, ... Associate's Degree - Nursing degree/diploma upon hire. + Washington Registered Nurse License upon hire. + 2...+ 1 year - experience in care management or utilization review in any setting or successful… more
- Actalent (Everett, WA)
- Job Title: Registered Nurse ( RN ) Case Manager Job Description We are seeking a compassionate and highly skilled RN Case Manager to join our dynamic team ... care nursing experience. + Strong knowledge of discharge planning, utilization review , and care coordination principles. +...review , care coordination, and discharge planning. + Prefer RN with experience in ED, Labor & Delivery, NICU,… more
- Pacific Medical Centers (Seattle, WA)
- … Nurse License. + 5 years Clinical experience. + Utilization review /case management. **Preferred Qualifications:** + Bachelor's Degree Nursing. + ... Care patient in order to assure cost effective, appropriate utilization of health care resource. Nurse Case...effective, appropriate utilization of health care resource. Nurse Case Manager manages, directs, and coordinates the entire… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …(2) years of acute hospital clinical experience + Current licensure as a Registered Nurse in the state of Washington ( RN -WA) + BLS required within 3 months ... the way our patient care is delivered. As a Registered Nurse at Virginia Mason you are...+ Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used We deliver inspired… more
- Seattle Children's (Seattle, WA)
- …for children with medical complexity Current or previous hospital case management or utilization review experience Current or previous case management or ... in a clinical setting **Required Credentials** Current Washington State RN license. National certification in case management must be...utilization review leadership experience **Compensation Range** $118,174.00 - $177,262.00 per… more
- University of Washington (Seattle, WA)
- …to support successful testimony in ITA court + Attend treatment team, utilization review , quality improvement and other meetings as requested/required. Attend ... Degree as required by specialty + Licensed as a psychologist, advanced registered nurse practitioner, mental health counselor or independent clinical social… 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 ... **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Swedish Health Services (Seattle, WA)
- …beyond three years is contingent upon attaining the BSN degree + Upon hire: Washington Registered Nurse License + 3 years Registered nursing experience in an ... **Description** **Care Manager RN - Emergency Department @ Swedish First Hill**...focus on what really matters - our patients.** The nurse case manager coordinates the care and service of… more
- LifeCenter Northwest (Bellevue, WA)
- …availability, evening, and weekend work. EDUCATION, EXPERIENCE & JOB REQUIREMENTS + Registered Nurse , Physician's Assistant, or other relevant health care ... donor management protocols aimed at optimizing organ function and increasing organ utilization . + Routinely reviews performance metrics and recommends changes in… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …transplant services, including program workflows, staffing, budgets, and resource utilization + Develops and implements clinic-specific customer service, human ... standards (eg, CMS, UNOS/OPTN, JCAHO/Joint Commission, state-level regulations) + Develop, review , and enforce program policies and clinical protocols **10% Human… more
- Elevance Health (Seattle, WA)
- **Telephonic Nurse Case Manager II** **Sign on Bonus: $2000.** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the… more