• Utilization Review RN

    Providence (Everett, WA)
    …in consultation with the Human Resources leader. + Upon hire: Washington Registered Nurse License + Experience as an RN in an acute care setting within ... years, OR recent Utilization Management experience **Preferred Qualifications:** + Utilization review or case management experience + Experience with… more
    Providence (01/22/25)
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  • Utilization Review RN

    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
    Swedish Health Services (01/16/25)
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  • Utilization Review Nurse

    University of Washington (Seattle, WA)
    …) **UW Medical Center** has an outstanding opportunity for an **experienced Utilization Review Nurse (UM RN )** to join our team. **WORK SCHEDULE** + ... Req #: 236354 Department: UW MEDICAL CENTER - UTILIZATION MANAGEMENT Job Location Detail: Position supports both...and training + Active licensure to practice as a Registered Nurse in Washington State required by… more
    University of Washington (01/22/25)
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  • Medical Claim Review Nurse

    Molina Healthcare (Seattle, WA)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (01/25/25)
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  • Care Review Clinician, Inpatient…

    Molina Healthcare (Seattle, 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 (01/23/25)
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  • RN , Care Manager

    Whidbey General Hospital (Coupeville, WA)
    …background to assure compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning. The RN - Care Manager will lead an ... an RN + Minimum of two years current experience as an RN in utilization review , case management and/or discharge planning in a hospital inpatient acute… more
    Whidbey General Hospital (12/19/24)
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  • RN Care Coordinator

    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 (12/24/24)
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  • Care Coordinator RN

    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
    Virginia Mason Franciscan Health (01/28/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Mount Vernon, 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
    Fresenius Medical Center (12/31/24)
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  • Clinical Manager Home Health Full Time

    CenterWell (Seattle, 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
    CenterWell (01/11/25)
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  • Care Manager RN - Usfhp

    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
    Pacific Medical Centers (01/06/25)
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  • Investigator, SIU RN

    Molina Healthcare (Seattle, 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 (01/21/25)
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  • Manager, Case Management and UR

    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
    Seattle Children's (11/21/24)
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  • Clinical Documentation Specialist

    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
    Houston Methodist (12/03/24)
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  • Care Manager RN

    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 of Registered nursing ... **Description** **Care Manager RN @ Swedish Ballard** **Full Time 1 FTE**...focus on what really matters - our patients.** The nurse case manager coordinates the care and service of… more
    Swedish Health Services (01/14/25)
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  • Care Manager RN

    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
    Swedish Health Services (12/25/24)
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  • COE CM Director, ( RN required)

    Molina Healthcare (Seattle, 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 (01/21/25)
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  • Wound Care UM RN

    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
    Elevance Health (12/18/24)
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  • Manager Of Program Operations - Ambulatory…

    University of Washington (Seattle, WA)
    …to finish working closely with the CTO Regulatory coordinators to manage, review , and initiate trials to ensure competitive activation and enrollment timelines + ... managing business operations (including financial and related information systems), utilization management and productivity for the Ambulatory Research and Clinical… more
    University of Washington (01/16/25)
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