- 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
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary range ... assistance may be available.** **Job Summary** Responsible for promoting effective utilization and monitoring of healthcare resources. This position will assume an… 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 of Utilization Review, Care Management , Quality Management , and/or Discharge planning… 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
- 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
- Molina Healthcare (Spokane, WA)
- …ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) ... modification of payment decisions. + Serves as a clinical resource for utilization management , CMOs, physicians and member/provider inquiries/appeals. + Provides… more
- Battelle Memorial Institute (Tacoma, WA)
- …as a case manager by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing Center + At least two ... Research and Analytics (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support of our government customer,… more
- Veterans Affairs, Veterans Health Administration (Vancouver, WA)
- Summary The Purchased Geriatrics & Extended Care Registered Nurse provides care and counseling of persons and supports the promotion and maintenance of health and ... that demonstrate leadership, experience, and creative approaches to the management of complex patient care. Duties include, but not...to evaluate programs and/or service activities. Is an expert nurse who practices at the systems level in roles… 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 (Vancouver, 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
- Molina Healthcare (Yakima, 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
- 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, and ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… 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
- Virginia Mason Franciscan Health (Kirkland, WA)
- …in their professional development. + Ensuring optimal patient flow and efficient utilization of resources to meet the demand for services. + Addressing patient ... Required: + This position requires current licensure as a registered nurse plus one years' increasingly responsible health care operations experience. +… 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
- Pacific Medical Centers (Renton, WA)
- …The Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family ... USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly...(must be RN) And + Upon hire: Washington Registered Nurse License + 5 years Clinical experience **Preferred Qualifications:**… more
- Molina Healthcare (Everett, 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