- Trusted Resource Associates (TRA) (Palm Springs, CA)
- Trusted Resource Associates (TRA) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Palm Springs, California.Job ... Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 09/25/2024Duration: 13 weeks40 hours per...Must be available to work 8 am to 5pm Pacific Time or during hospital business hours. - Must… more
- Molina Healthcare (Riverside, CA)
- …seeking a LVN (Licensed Vocational Nurse ) with experience in Prior Authorizations, Utilization Review / Utilization Management and knowledge of Interqual ... 3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active,… more
- Providence (Everett, WA)
- …services across multiple units and serves as the site administrator at PRMCE Pacific Campus. Assures that the provision of nursing services are integrated and in ... a focus on highly reliable care, performance improvement and appropriate utilization of resources. Assumes an active leadership role inter-professionally and works… more
- Molina Healthcare (Bowling Green, KY)
- … Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual ... Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more
- Molina Healthcare (Riverside, CA)
- … Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual ... **INPATIENT REVIEW : REGISTERED NURSE ** **WORK SCHEDULE: 5 days / daytime work...or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current… more
- Molina Healthcare (Las Vegas, NV)
- …compact state at this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes will be essential for this role.** **JOB ... **JOB TITLE : Nurse (REGISTERED NURSE ) Lead, Healthcare Services...3-5 years clinical practice with managed care, hospital nursing, utilization and/or care management experience. **Preferred License,… more
- J&J Family of Companies (Portland, OR)
- Advanced Practice Provider Ambassador Gastroenterology ( Pacific Northwest) - 2406208438W **Description** Johnson & Johnson Innovative Medicine (JJIM) is recruiting ... for an Advanced Practice Provider Ambassador, Gastroenterology, in the Pacific Northwest territory. At JJIM what matters most is helping people live full and healthy… more
- Hawaii Pacific Health (Honolulu, HI)
- …related field **Preferred Qualifications:** Current Case Management or Utilization Management certification. EOE/AA/Disabled/Vets Hawai'i Pacific Health ... internal medicine, vascular and urology. Straub is home to the Pacific Region's only multidisciplinary burn treatment center. The hospital consistently brings… more
- Pacific Medical Centers (Seattle, WA)
- …Registered Nurse License. + 5 years Clinical experience. + Utilization review/case management . **Preferred Qualifications:** + Bachelor's Degree Nursing. + ... Medical Centers' Managed Care patient in order to assure cost effective, appropriate utilization of health care resource. Nurse Case Manager manages, directs,… more
- Molina Healthcare (NV)
- …not a compact state at this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes and 3 + years in management / ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
- Pacific Medical Centers (Seattle, WA)
- …administrative functions needed to support a smooth, efficient referral process; assists the utilization review and case management nurse with management ... simply valued - they're invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built… more
- Hawaii Pacific Health (Aiea, HI)
- …(CDI) certification. Experience with InterQual, Milliman or other nationally recognized Utilization Management criteria. Experience with DRGs or inpatient ... through extensive interaction with physicians, nursing, other patient caregivers, Case Management and Health Information Management staff. You will also… more
- Elevance Health (Seattle, WA)
- ** Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office) and participate in health plan sponsored ... office locations. **Work Hours:** 8:00 AM to 5:00 PM Pacific time - holidays and weekends may be required...time - holidays and weekends may be required The ** Utilization Management Representative I** is responsible for… 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 Nursing Or + Associate's Degree Nursing + 3 years Utilization Review, Care Management , Quality Management , and/or Discharge planning… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …are now united to build the future of patient-centered care across the Pacific Northwest. That means a seamlessly connected system offering quality care close to ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is...hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year… more
- Defense Health Agency (Tacoma, WA)
- **Overview** Nurse (Clinical/Ambulatory) Tacoma, WA Located in the beautiful Pacific Northwest on the Puget Sound, in Washington State, Joint Base Lewis-McChord ... to the deep waters of Puget Sound and the Pacific Ocean, the local areas abound in natural beauty...and face-to-face care, to include care coordination and transition management , triage, invasive and non-invasive procedures, nurse … more
- Providence (Everett, WA)
- **Description** Under the direct supervision of the Nurse Manager, provides direct nursing service supervision on the unit ensuring comprehensive nursing services ... and quality patient care. Assists with day-to-day management of unit operations. Assists with oversight of clinical and resource utilization , patient throughput,… more
- Sutter Health (San Francisco, CA)
- … Pacific Med Center Davies **Position Overview:** Coordinates the utilization management , resource management , discharge planning, post-acute ... care referrals and care facilitation. Oversees the management of acute patient populations across the care continuum with a focus to provide coordinated and… more
- Providence (Centralia, WA)
- …supervision on the unit ensuring comprehensive and quality patient care. The Assistant Nurse Manager assists with day-to-day management of unit operations. This ... position assists with oversight of clinical and resource utilization , patient throughput, quality assessment and improvement, patient/staff/provider satisfaction,… more
- University of Washington (Seattle, WA)
- …Medicine** **Harborview Medical Center** has an outstanding opportunity for a **Registered Nurse (RN)** to work in our **Pioneer Square Downtown programs Field Based ... orders * Provide health education, transitions of care and support chronic disease management in conjunction with primary care provider and community health worker *… more
