- Molina Healthcare (Vancouver, WA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2… more
- Whidbey General Hospital (Coupeville, WA)
- …etc. The RN - Care Manager follows the hospital's Case Management /Utilization Plan that integrates the functions of utilization review, discharge planning, and ... management either during admission or post discharge. The RN - Care Manager acts as a resource to...Patient Access, Patient Financial Services (PFS) and Health Information Management (HIM), as appropriate. + Escalates Medical … more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …and Certifications Preferred: Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ) or UM Certification preferred. **Where You'll Work** Virginia ... **Job Summary and Responsibilities** Job Summary / Purpose The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for… more
- Molina Healthcare (WA)
- …with multidisciplinary teams to promote Molina care model. * Adheres to utilization management ( UM ) policies and procedures. * May work collaboratively with ... collaborate and coordinate with behavioral health medical directors, and senior medical directors to ensure proper management of the BHT benefit. Required… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- … professional nurse who exemplifies leadership and oversees registered nurse ( RN ) and advanced medical support assistant (AMSA) staff within ... Washington. The Nurse Manager directly supervises the RN Utilization Management /Discharge Planners, AMSA Discharge Coordinators,...RNs, and Traveling Veteran Coordinators. Responsibilities The Nurse Manager (NM) is a registered… more
- Datavant (Olympia, WA)
- …job function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...Word, Excel, Outlook, experience working in a health plan medical management documentation system a plus. Minimum… more
- Evolent (Olympia, WA)
- …mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance ... for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices of...under the auspices of the office of the Chief Medical Officer. **ESSENTIAL DUTIES AND RESPONSIBILITIES** : include the… more
- Highmark Health (Olympia, WA)
- …:** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over a ... in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and utilizing...in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced training and… more
- CVS Health (Olympia, WA)
- …years of regulatory and/or clinical audit experience. + Experience in medical management , including Utilization Management ( UM ) and Case Management ... accreditation processes, and NCQA standards. + Licensed clinical professional ( RN preferred). + Excellent analytical, organizational, and communication skills. +… more