• RN , Care Manager

    Whidbey General Hospital (Coupeville, WA)
    JOB SUMMARY Are you a flexible, self-motivated RN who thrives in a collaborative, fast-paced environment? At WhidbeyHealth, our Care Managers play a vital role in ... at the right time-we'd love to meet you! The RN - Care Manager is a health care professional...working knowledge of payer contracts and regulatory requirements and UM specific changes (ie, changes in authorizations, payer contracts,… more
    Whidbey General Hospital (10/01/25)
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  • Care Coordinator RN

    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
    Virginia Mason Franciscan Health (10/30/25)
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  • Care Review Clinician RN (BH Licensed)

    Molina Healthcare (WA)
    …teams to promote Molina care model. * Adheres to utilization management ( UM ) policies and procedures. * May work collaboratively with appropriate departments to ... License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). RN licensure preferred **Nevada State Specific Requirements:** Must be… more
    Molina Healthcare (11/21/25)
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  • Nurse Manager - Patient Access Center…

    Veterans Affairs, Veterans Health Administration (Seattle, WA)
    …is a registered professional nurse who exemplifies leadership and oversees registered nurse ( RN ) and advanced medical support assistant (AMSA) staff ... services at the VA hospital in Seattle, Washington. The Nurse Manager directly supervises the RN Utilization...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (11/16/25)
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  • 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...table:** + Two (2) years managed care experience in UM /CM/CDI Department preferred + Knowledge of CMS, State Regulations,… more
    Datavant (11/12/25)
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  • Clinical Reviewer, Nurse

    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 ... P2P discussions with one of the cardiologists. Responsible for coordinating with UM staff to ensure timely and accurate communication of clinical decisions.… more
    Evolent (11/20/25)
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  • Manager, Business Compliance

    CVS Health (Olympia, WA)
    …audit experience. + Experience in medical management, including Utilization Management ( UM ) and Case Management (CM). + Strong understanding of healthcare quality, ... accreditation processes, and NCQA standards. + Licensed clinical professional ( RN preferred). + Excellent analytical, organizational, and communication skills. +… more
    CVS Health (11/19/25)
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  • Transplant Care Nurse (Remote)

    Highmark Health (Olympia, WA)
    …experience + 1 year in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced training and experience in cognitive behavioral ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...or WV or DE or NY is required. Other RN license(s), if applicable, must be obtained within the… more
    Highmark Health (11/06/25)
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