• Care Review Clinician RN (BH…

    Molina Healthcare (WA)
    …to other clinical programs. * Collaborates with multidisciplinary teams to promote Molina care model. * Adheres to utilization management ( UM ) policies and ... experience with MCG guidelines. At least 2 years of experience with inpatient concurrent review , prior authorization and managed care ; Acute care hospital… more
    Molina Healthcare (11/21/25)
    - Related Jobs

  • Supervisor Care Management RN…

    Pacific Medical Centers (Renton, WA)
    …+ Coursework/Training Nursing (must be RN ) And + Upon hire: Washington Registered Nurse License + 5 years Clinical experience **Preferred Qualifications:** + ... **Description** The Supervisor Care Management RN is responsible for...the supervision of case management (CM) and utilization management ( UM ) functions of US Family Health Plan to achieve… more
    Pacific Medical Centers (10/11/25)
    - Related Jobs

  • RN , Care Manager

    Whidbey General Hospital (Coupeville, WA)
    …CMS Conditions of Participation regarding Utilization Review and Discharge Planning. The RN - Care Manager will lead an assessment to identify the patient's ... at the right time-we'd love to meet you! The RN - Care Manager is a health...within the Transitions Department. + Performs pre-admission status recommendation review for multiple care settings as assigned… more
    Whidbey General Hospital (10/01/25)
    - Related Jobs

  • Care Coordinator RN

    Virginia Mason Franciscan Health (Silverdale, WA)
    **Job Summary and Responsibilities** Job Summary / Purpose The RN Care Coordinator is responsible for overseeing the progression of care and discharge ... planning for identified patients requiring these services. The RN Care Coordinator performs this role to meet the individual's health needs while promoting… more
    Virginia Mason Franciscan Health (10/30/25)
    - Related Jobs

  • Denials Prevention Specialist, Clinician PRN

    Datavant (Olympia, WA)
    …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...bring to the table:** + Two (2) years managed care experience in UM /CM/CDI Department preferred +… more
    Datavant (11/12/25)
    - Related Jobs

  • Transplant Care Nurse (Remote)

    Highmark Health (Olympia, WA)
    …and/or triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established ... in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced...in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
    Highmark Health (11/06/25)
    - Related Jobs

  • Clinical Reviewer, Nurse…

    Evolent (Olympia, WA)
    …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support… more
    Evolent (11/20/25)
    - Related Jobs