- Providence (Olympia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... of the department.** **Required qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of...Degree Or Associate's Degree Nursing + 3 years of Utilization Review , Care Management, Quality Management, and/or… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- Summary The VA Puget Sound Healthcare System is recruiting for one Registered Nurse to perform patient flow utilization management duties at the VA hospital ... in Seattle, Washington. Responsibilities The Utilization Management (UM) Nurse uses the nursing...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Molina Healthcare (Tacoma, WA)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Molina Healthcare (Tacoma, WA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... care/medical experience. R **equired License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. MULTI… more
- CVS Health (Olympia, WA)
- …care. - Perform medical necessity reviews. **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. - A Registered Nurse that holds an active, unrestricted...lower levels of care. - 1+ years' experience in Utilization Review . - CCM and/or other URAC… more
- CVS Health (Olympia, WA)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Muckleshoot Indian Tribe (Auburn, WA)
- …also instruct patients and their families how to perform necessary procedures. A Registered Nurse administers skilled nursing care to patients on an intermittent ... and performance improvement as assigned. + Participates in utilization review of medical records as assigned....Licenses or Certifications Required Current and valid Washington State Registered Nurse licensure. A current and valid… more
- CenterWell (Tacoma, 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 (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 ... **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression of...+ Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. Preferred + Bachelor's… more
- Providence (Olympia, WA)
- …hires that meet required qualifications and conditions for payment.** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, ... Degree Nursing degree/diploma upon hire + Upon hire: Washington Registered Nurse License + 2 years Acute...Inpatient setting + IRR or annual competency testing in Utilization Review **Preferred qualifications:** + Bachelor's Degree… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …experience. **Licensure and Certifications:** Required + Current licensure as a Registered Nurse in the state of Washington ( RN -WA). + BLS required within 3 ... to their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Qualifications** **Education and Experience** Required… more
- Fresenius Medical Center (Renton, WA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Molina Healthcare (Tacoma, WA)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
- Sharecare (Olympia, WA)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… 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 ... Center model for ensuring the timely, efficient and cost-effective utilization of bed resources on a regional basis. Work...CHI-FH facilities. Job duties require the services of a Registered Nurse who, based on training and… 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
- Molina Healthcare (Tacoma, WA)
- …abuse through the identification of aberrant coding and/or billing patterns through utilization review . * Incorporate leadership and communication skills to work ... care experience. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) license in good standing. **PREFERRED… more
- Providence (Olympia, WA)
- …setting. + **Leadership Experience:** Minimum 3 years managing care coordination. Utilization review knowledge preferred. + **Independent Leadership:** Proven ... **Physician Relations:** Build strong cooperative relationships with physicians. + ** Utilization Management Oversight:** Lead the Utilization Management… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …and safe patient care. **Qualifications** Bachelor's degree required. Current licensure as a Registered Nurse in the state of Washington required. At least three ... in Emergency Medicine, Critical Care or Telemetry. Knowledge of utilization review desirable. We are an equal...Critical Care or Telemetry. Knowledge of utilization review desirable. We are an equal opportunity/affirmative action employer.… 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** $115,277.00 - $172,915.00 per… more