• Utilization Review RN

    Providence (Portland, OR)
    **Description** The RN Coordinator- Utilization Review supports the care of the patient through assessment, planning, implementation and evaluation of ... experience in lieu of a Bachelor's Degree. + Oregon Registered Nurse License upon hire. + 5...in an acute adult medical/surgical care setting, OR Current Utilization Review or Case Management experience. +… more
    Providence (01/10/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, Inpatient…

    Molina Healthcare (Vancouver, 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
    Molina Healthcare (01/13/25)
    - Save Job - Related Jobs - Block Source
  • RN Clinical Manager, Home Health

    CenterWell (Lake Oswego, OR)
    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
    CenterWell (10/30/24)
    - Save Job - Related Jobs - Block Source
  • Investigator, SIU RN

    Molina Healthcare (Vancouver, 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
    Molina Healthcare (01/13/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse

    Insight Global (Oregon City, OR)
    …-Triages minor to emergent situations. -Respond to medical emergencies. -Performs nurse visits and administers medications and immunizations as ordered by an ... primary care procedures as necessary in times of staffing constraints. -Performs RN led patient visits for health maintenance, patient education, and treatment of… more
    Insight Global (11/08/24)
    - Save Job - Related Jobs - Block Source
  • Lead, Auditor ( RN ) Appeals & Grievances…

    Molina Healthcare (Vancouver, 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
    Molina Healthcare (01/13/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, Inpatient…

    Molina Healthcare (Vancouver, WA)
    …acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must ... or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
    Molina Healthcare (01/13/25)
    - Save Job - Related Jobs - Block Source
  • COE CM Director, ( RN required)

    Molina Healthcare (Vancouver, WA)
    …License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) license in good standing. + Utilization Management Certification ... _This position requires an actively licensed Registered Nurse_ **JOB DESCRIPTION** **Job Summary** The mission of Clinical Operations is to drive value through an… more
    Molina Healthcare (12/12/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Design Director ( RN required)

    Molina Healthcare (Vancouver, 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
    Molina Healthcare (01/13/25)
    - Save Job - Related Jobs - Block Source