• RN UM Clinical Appeals Nurse

    Molina Healthcare (Tacoma, WA)
    …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours:… more
    Molina Healthcare (11/14/25)
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  • Case Manager - UM II -100%

    Healthfirst (WA)
    …+ Occasional overtime as necessary + Additional duties as assigned Minimum Qualifications: + RN , LPN, LMSW, LMHC, LMFT, LCSW, PT, OT, and/or ST license + For CASAC ... positions only: Credentialed Alcohol and Substance Abuse Counselor Preferred Qualifications: + Masters degree in a related discipline + Experience in managed care, case management, identifying alternative care options, and discharge planning + Certified Case… more
    Healthfirst (11/25/25)
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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 ... the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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  • Care Coordinator RN

    Virginia Mason Franciscan Health (Silverdale, WA)
    …experience. **Licensure and Certifications:** Required + Current licensure as a Registered Nurse in the state of Washington ( RN -WA). + BLS required within 3 ... within hospital Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred **Where You'll Work** Virginia Mason… more
    Virginia Mason Franciscan Health (11/16/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Bellevue, WA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical...the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications** * At least… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (Spokane, WA)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (11/06/25)
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  • Supervisor Care Management RN - Usfhp

    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...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)
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  • Utilization Management Nurse - Home…

    Humana (Olympia, WA)
    …Standard Time **Required Qualifications** + Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a compact state with no disciplinary ... and independent determination of the appropriate courses of action. As a Utilization Management RN working on the OneHome/Home Solutions UM Team, you will have… more
    Humana (09/12/25)
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  • RN - Utilization Review

    Providence (Olympia, WA)
    …people, we must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of Nursing **Preferred Qualification:** ... **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with...blended with well-developed knowledge and skills in Utilization Management ( UM ), medical necessity and patient status determination. This individual… more
    Providence (11/06/25)
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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 ... teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2 years experience,… more
    Molina Healthcare (11/21/25)
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