- Swedish Health Services (Seattle, WA)
- **Description** ** Utilization RN ** **Per diem** **Remote 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 … more
- 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
- 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
- Pacific Medical Centers (Renton, WA)
- … Nurse License. + 5 years Clinical experience. + Utilization review /case management. **Preferred Qualifications:** + Bachelor's Degree in Nursing ... cost effective, appropriate utilization of health care resource. Utilization Nurse / Case Manager manages, directs, and coordinates the entire spectrum… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- Summary Registered Nurse ( RN ) Utilization Management (UM) delivers knowledge-based care to clients while developing technical skills. Assesses, plans, ... The Nurse Utilization Management (UM) Registered Nurse ( RN ) is responsible...care Bachelor of Science in Nursing Case Management Experience Utilization Management/ Review experience Physical Requirements: Heavy lifting… more
- Molina Healthcare (Bellevue, 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 (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
- 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
- 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
- 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)
- …as directed by supervisors. Duties include but not limited to: Inpatient Staff Registered Nurse ( RN ) is responsible for providing competent, evidence-based ... of Science in Nursing Minimum of 1-2 years experience as registered nurse Previous acute care experience Experience administering chemotherapy/biotherapy… more
- Molina Healthcare (Bellevue, 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
- 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
- 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 1...focus on what really matters - our patients.** The nurse case manager coordinates the care and service of… more
- Molina Healthcare (Bellevue, 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
- 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
- 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