- CenterWell (Olympia, WA)
- …our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
- Molina Healthcare (Tacoma, WA)
- …**Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services ... are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through… more
- Evolent (Olympia, WA)
- …coordinating with UM staff to ensure timely and accurate communication of clinical decisions. + Responsible for completion of UM projects and participation ... the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Vascular Surgey is responsible for support and… more
- Evolent (Olympia, WA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member...medical management activities in a managed care environment + UM /UR experience + Clinical experience in Oncology,… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- …VA Puget Sound Healthcare System is recruiting for a Detail, NTE Six Months, Nurse Manager to perform supervisory duties with the Patient Access Center and Patient ... Flow services at the VA hospital in Seattle, Washington. The Nurse Manager directly supervises the RN Utilization Management/Discharge Planners, AMSA Discharge… more
- Humana (Olympia, WA)
- …us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation… more
- Highmark Health (Olympia, WA)
- …experience, or provider operations and/or health insurance experience + 1 year in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year ... panel of members that range in health status/severity and clinical needs; and assesses health management needs of the...RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or… more
- PeaceHealth (Vancouver, WA)
- …wherever you are._** PeaceHealth is looking for a skilled and motivated **Registered Nurse Utilization Management ( UM ) Reviewer** to join our dedicated team in ... across our healthcare system. This position centers on **concurrent and retrospective UM reviews** , leveraging clinical expertise, payer policy knowledge, and… more
- PeaceHealth (Vancouver, WA)
- …wherever you are._** PeaceHealth is looking for a skilled and motivated **Registered Nurse Utilization Management ( UM ) Reviewer** to join our dedicated team in ... across our healthcare system. This position centers on **concurrent and retrospective UM reviews** , leveraging clinical expertise, payer policy knowledge, and… more
- Providence (Olympia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management ( ... UM ), medical necessity and patient status determination. This individual...empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years - Nursing **Preferred Qualifications:**… more