• Medical Claim Review Nurse

    Molina Healthcare (Vancouver, 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 (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 (01/23/25)
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  • 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)
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  • 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 (01/21/25)
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  • Clinic Registered Nurse

    Insight Global (Hillsboro, 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 (12/23/24)
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  • Care Manager RN

    Providence (Portland, OR)
    …Bachelor's degree in Nursing or higher within 3 years of hire. + Upon hire: Oregon Registered Nurse License + 2 years of Acute care hospital or community based ... **Description** **Care Manager RN at Providence Portland Medical Center in Portland,...year of Home health, mental health, substance use, hospice, utilization review , discharge planning or care management… more
    Providence (01/22/25)
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  • 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)
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