- Providence Health and Services (Tumwater, WA)
- …overtime, premiums, extra shift incentives, or bonus opportunities. PandoLogic. Category:Healthcare, Keywords: Utilization Review Nurse , Location:Tumwater, ... Description The Utilization Review (UR) Nurse ...Description The Utilization Review (UR) Nurse has a strong...we must empower them. Required Qualifications: Upon hire: Washington Registered Nurse License 3 years of Nursing… more
- Providence Health and Services (Tumwater, WA)
- Description The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient centric care management services for at risk ... overtime, premiums, extra shift incentives, or bonus opportunities. PandoLogic. Category:Healthcare, Keywords: Registered Nurse ( RN ), Location:Tumwater,… more
- Parexel (Olympia, WA)
- …reproducible research practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable health professional credentials, ... solutions, and ensure high-quality, compliant data. + Use surveillance tools to review data at an aggregate level, identifying patterns or anomalies to ensure… more
- Humana (Olympia, WA)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- Providence (Olympia, WA)
- **Description** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient centric care management services for at risk ... in 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
- 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
- CVS Health (Olympia, WA)
- …however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating ... - Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit...**Required Qualifications** Must have an active, current and unrestricted RN licensure in the state of residence and be… more
- General Dynamics Information Technology (Lakewood, WA)
- …Center. + Current RN license; full, active, and unrestricted license as a Registered Nurse in one of any US State, the District of Columbia, Guam, ... proof of all training/certs/documentation. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential… more
- CenterWell (Olympia, WA)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
- Datavant (Olympia, WA)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Humana (Olympia, WA)
- …timeframe **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) Compact license, with no disciplinary action ... caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes...Health Provider Disputes based on the business need + Review and extract information from claims + Work in… more
- Highmark Health (Olympia, WA)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- Highmark Health (Olympia, WA)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Evolent (Olympia, WA)
- …mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance ... for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices...UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory… more
