- Swedish Health Services (Seattle, WA)
- …** Utilization Review RN ** **Full time 1 FTE** **Day Shift** The Utilization Review (UR) Nurse has a strong clinical background blended with a ... well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination....an accredited school of nursing. + Upon hire: Washington Registered Nurse License + 3 years Med/Surg… more
- Molina Healthcare (Bellevue, WA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …Nursing field in lieu of 1 year experience. + Current licensure as a Registered Nurse in the state of Washington ( RN -WA). + BLS required within 3 months of ... located within hospital + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. Preferred + Bachelor's Degree in Nursing… more
- Virginia Mason Franciscan Health (Burien, 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
- CenterWell (Silverdale, 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
- 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
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… 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
- Houston Methodist (Seattle, WA)
- …- One year of clinical experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact ... an acute care hospital setting is required; coding and utilization review experience preferred + For Medical...State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
- Molina Healthcare (Seattle, WA)
- …production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management ... to resolve/correct them.. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or… 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 ... **Description** **Care Manager RN @ Swedish Cherry Hill** **Full Time Day...focus on what really matters - our patients.** The nurse case manager coordinates the care and service of… more
- Swedish Health Services (Seattle, WA)
- …by Swedish beyond three years is contingent upon attaining the BSN degree + Washington Registered Nurse License upon hire + 3 years registered nursing ... **Description** **Care Manager RN @ Swedish First Hill** **$10,000 Hiring Bonus...focus on what really matters - our patients.** The nurse case manager coordinates the care and service of… more
- Elevance Health (Seattle, WA)
- …hour commute of an Elevance Health Office The Wound Care UM RN is responsible for performing pre-certification certification and/or authorization activities for Home ... care for wound care. + Promotes healing and decrease home care utilization . + Responsible for certification determinations and sending written authorizations to… more
- Molina Healthcare (Seattle, WA)
- …License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) license in good standing. + Utilization Management Certification ... _Candidates must possess a current RN license, as well as a Bachelor's Degree_...results across Molina Health Plans & Segments. **KNOWLEDGE/SKILLS/ABILITIES** + Review existing standards and processes and establish new standards… more
- Elevance Health (Seattle, WA)
- ** Nurse Reviewer I** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** **Work ... Monday - Friday 9:30am to 6:00pm depending on your time zone.** The ** Nurse Reviewer I** is responsible for conducting preauthorization, out of network and… more
- Molina Healthcare (Bellevue, WA)
- …License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) license in good standing. + Utilization Management Certification ... following key Healthcare Services functions: case management/disease management/care transitions; utilization management (Position oversees PA authorizations and manages the… more