- Novo Nordisk Inc. (Seattle, WA)
- …include key opinion leaders (KOL's), academic institutions, physicians, nurse practitioners, diabetes educators, pharmacists, blood bank staff, organized ... policies, legal, regulatory, and compliance requirements Ensures effective administrative management of regional business as well as operational budgets Maintains… more
- Humana (Olympia, WA)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Olympia, WA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Olympia, WA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Elevance Health (Seattle, WA)
- ** Utilization Management Representative II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... AM and 5:00 PM Pacific. The **Behavioral Health (BH) Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
- Providence (Olympia, WA)
- …a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. ... + Bachelor's Degree or Associate's Degree in Nursing + 3 years - Utilization Review, Care Management , Quality Management , and/or Discharge planning… more
- Defense Health Agency (Tacoma, WA)
- …appropriate priorities; responsiveness to emergencies; effectiveness of practice, patient management , bed utilization ; customer service and relations; open ... **Overview** ** NURSE (Labor and Delivery), Tacoma, WA** **This position...throughout hospitalization g. Participates in Quality Improvement, Internal Control Management Program, and Utilization Training. Provides neonatal… more
- Pacific Medical Centers (Renton, WA)
- …administrative functions needed to support a smooth, efficient referral process; assists the utilization review and case management nurse with management ... of referrals and monitoring or institutional patients. Providence caregivers are not simply valued - they're invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers in our culture of patient-focused, whole-person care built on understanding,… more
- Elevance Health (Seattle, WA)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... ** Nurse Reviewer I** **Virtual:** This role enables associates...required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
- General Dynamics Information Technology (Lakewood, WA)
- …a case manager by a recognized certifying organization, ie Commission for Case Management Certification or American Nurse Credentialing Center. + Current RN ... Yes **Job Description:** Seize your opportunity to make a personal impact as Nurse Case Manager supporting mission critical work on an exciting program. GDIT is… more
- Molina Healthcare (Tacoma, WA)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
- University of Washington (Seattle, WA)
- …least one of the following: certified healthcare chart auditor, certified professional in utilization review (or utilization management or healthcare ... Services Department** has an outstanding opportunity for a **Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + 100% FTE + 100% Remote + Days **POSITION… more
- Molina Healthcare (Shelton, WA)
- …post-discharge coordination to reduce hospital readmission rates and emergency room utilization . * Performs face-to-face in-person visits in a variety of settings ... states besides home state based on business need. * Collaborates with fellow nurse practitioners to develop best practices to perform work duties efficiently and… more
- Sea Mar Community Health Centers (Seattle, WA)
- …assist providers in procedures. + Facilitate emergency referrals according to the utilization management guidelines when the referral coordinator is unavailable. ... to patients who have yet to be seen. Responsible for management of nurse visit encounters. These will include fast-track immunizations; annual employee… more
- Evolent (Olympia, WA)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- University of Washington (Seattle, WA)
- …has an outstanding opportunity for an experienced acute care Nurse Manager to work on our **Cardiology/Cardiothoracic unit.** **DEPARTMENT DESCRIPTION** ... best practices + Monitor patient flow, throughput, and resource utilization to maintain efficiency in a fast-paced hospital environment...Nursing + Active licensure to practice as a Registered Nurse in Washington State + 6 years of clinical… more
- Fresenius Medical Center (Bonney Lake, WA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Molina Healthcare (Tacoma, WA)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Molina Healthcare (Tacoma, WA)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- Providence (Olympia, WA)
- …Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation ... **Description** The Inpatient Registered Nurse (RN) Care Manager provides professional, comprehensive, patient...specialty upon hire. + 1 year experience in care management or utilization review in any setting… more
