- Humana (Olympia, WA)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Baylor Scott & White Health (Olympia, WA)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Highmark Health (Olympia, WA)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Sharecare (Olympia, WA)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Highmark Health (Olympia, WA)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Providence (Centralia, WA)
- **Description** The Utilization Review RN provides assessment and analytical support to concurrent and retrospective quality and utilization activities, ... qualifications:** + Associate Degree Nursing. + Upon hire: Washington Registered Nurse License + 3 years Medical-surgical...+ 1-year Recent acute care experience. + Quality and/or utilization review and/or case management … more
- Centene Corporation (Olympia, WA)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Providence (Olympia, WA)
- …the best people, we must empower them. **Required qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of Acute care hospital or ... hire Care Manager Certification + 1 year of Care management , discharge planning, or utilization management...Shift:** Multiple shifts available **Career Track:** Nursing **Department:** 3030 UTILIZATION REVIEW WA PSPH OLYMPIA MAIN 2ND… more
- Guardian Life (Olympia, WA)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Centene Corporation (Olympia, WA)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Conduct review of delegated entities for compliance with quality, service performance ... and utilization , credentialing reviews and medical record audits. Perform community...Document, investigate and resolve formal and informal complaints, risk management and sentinel events related to quality of care… more