• RN - Utilization Review

    Providence (Olympia, WA)
    **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of...Or Associate's Degree in Nursing + 3 years of Utilization Review , Care Management, Quality Management, and/or… more
    Providence (11/06/25)
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  • SNF Utilization Management RN

    Humana (Olympia, WA)
    …an impact** **Use your skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
    Humana (12/12/25)
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  • RN Admissions/ Utilization

    PeaceHealth (Bellingham, WA)
    …of psychiatric diagnostics. + Preferred: Third party reimbursement knowledge. + Preferred: Utilization Review experience, someone who can talk to providers. ... **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care...**Credentials** + Required: Registered Nurse in state of practice +… more
    PeaceHealth (12/06/25)
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  • RN Medical Review Nurse

    Molina Healthcare (Spokane, WA)
    … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical...our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The… more
    Molina Healthcare (12/03/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Vancouver, WA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (12/13/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Silverdale, 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
    CenterWell (11/25/25)
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  • RN - Care Manager - *1 FTE/Days

    Providence (Olympia, WA)
    …hires that meet required qualifications and conditions for payment.** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, ... Degree Nursing degree/diploma upon hire + Upon hire: Washington Registered Nurse License + 2 years Acute...Inpatient setting + IRR or annual competency testing in Utilization Review **Preferred qualifications:** + Bachelor's Degree… more
    Providence (12/05/25)
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  • Acute Inpatient Charge Registered

    Fresenius Medical Center (Spokane, WA)
    **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN , for a limited period of time, ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
    Fresenius Medical Center (11/11/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Bonney Lake, 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
    Fresenius Medical Center (11/18/25)
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  • Care Manager RN

    Providence (Walla Walla, WA)
    **Description** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient centric care management services for at risk ... Degree Nursing degree/diploma upon hire + Upon hire: Washington Registered Nurse License + 2 years Acute...setting + 1 year Experience in care management or utilization review in any setting or upon… more
    Providence (11/19/25)
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  • Care Manager RN

    Providence (Walla Walla, WA)
    **Description** The Inpatient Registered Nurse ( RN ) Care...+ 1 year - Experience in care management or utilization review in any setting or upon ... **Required Qualifications:** + Associate's Degree - Nursing degree/diploma upon hire. + Washington Registered Nurse License upon hire. + 2 years - Acute care… more
    Providence (11/19/25)
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  • Care Manager RN ED

    Providence (Everett, WA)
    …and development. Apply now and be a part of something extraordinary!The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, ... Associate's Degree - Nursing degree/diploma upon hire. + Washington Registered Nurse License upon hire. + 2...+ 1 year - experience in care management or utilization review in any setting or successful… more
    Providence (10/14/25)
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  • Transfer Center RN

    Virginia Mason Franciscan Health (Gig Harbor, WA)
    …work experience may be substituted for the Bachelor's degree. + Current, unencumbered ** Registered Nurse ( RN ) license in Washington state is REQUIRED** ... and Responsibilities** Are you a highly skilled and dynamic Registered Nurse with a passion for critical...You'll collaborate with a multi-disciplinary team (eg, care management, utilization review , finance) to address patient flow/bed… more
    Virginia Mason Franciscan Health (11/22/25)
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  • Clinical Documentation Specialist - RN

    Houston Methodist (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
    Houston Methodist (10/29/25)
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  • RN Care Coordinator

    Virginia Mason Franciscan Health (Seattle, WA)
    …(2) years of acute hospital clinical experience + Current licensure as a Registered Nurse in the state of Washington ( RN -WA) + BLS required within 3 months ... the way our patient care is delivered. As a Registered Nurse at Virginia Mason you are...+ Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used We deliver inspired… more
    Virginia Mason Franciscan Health (10/26/25)
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  • Director Care Management

    Providence (Olympia, WA)
    …setting. + **Leadership Experience:** Minimum 3 years managing care coordination. Utilization review knowledge preferred. + **Independent Leadership:** Proven ... **Physician Relations:** Build strong cooperative relationships with physicians. + ** Utilization Management Oversight:** Lead the Utilization Management… more
    Providence (10/07/25)
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  • Nurse Case Manager

    Battelle Memorial Institute (Tacoma, WA)
    …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report… more
    Battelle Memorial Institute (11/04/25)
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  • Care Manager RN (Delaware)

    Highmark Health (Olympia, WA)
    …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). + Delaware RN license must be obtained within… more
    Highmark Health (12/12/25)
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  • Nurse Case Manager

    General Dynamics Information Technology (Lakewood, WA)
    …Center. + Current RN license; full, active, and unrestricted license as a Registered Nurse in one of any US State, the District of Columbia, Guam, ... proof of all training/certs/documentation. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential… more
    General Dynamics Information Technology (10/26/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Spokane, WA)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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