- Molina Healthcare (WA)
- JOB DESCRIPTION **Job Summary** The Care Review Clinician (RN) provides support for clinical member services review assessment processes. Responsible for ... Hospital experience. Candidates with MCO experience are highly preferred. The Care Review Clinician must be able to work independently in a high-volume environment.… more
- Battelle Memorial Institute (Tacoma, WA)
- …within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...model allows you to work 60% in-office and 40% remote , with Monday and Tuesday as common in-office days,… more
- Providence (WA)
- …in a medical record. + 2 years - HEDIS, Quality management/quality improvement/ utilization review auditing experience, including experience in auditing within ... and Data Information Set (HEDIS) program + Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab and pharmacy records… more
- Providence (WA)
- …of Care Planning, Discharge Planning, Coordination of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review , Prior Authorization, Medical ... nearing end of life + Care management services include: nurse education, care coordination and general assistance with managing...care to our members **Providence Health Plan welcomes 100% remote work to residents who reside in the following… more
- Molina Healthcare (WA)
- …who must be licensed for the state they reside This role will be doing Utilization review for our Ohio Medicaid population, looking for clinicians with strong ... 8 AM to 5 PM EST This is a Remote position, home office with internet connectivity of high...DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are… more
- LifeCenter Northwest (Bellevue, WA)
- …donor management protocols aimed at optimizing organ function and increasing organ utilization . + Routinely reviews performance metrics and recommends changes in ... plans focused on optimizing organ function and increasing organ utilization . + Serves as a change agent for the...as well as other business environments, which may include remote work in a home office setting, if applicable… more