- Molina Healthcare (WA)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Bothell, WA)
- JOB DESCRIPTION Job Summary The Care Review Clinician ( RN ) provides support for clinical member services review assessment processes. Responsible for ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Bellevue, WA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Bellevue, WA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- 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 (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
- Highmark Health (Olympia, WA)
- …of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes… more
- 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 ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Elevance Health (WA)
- **Medical Management Clinician Associate** Carelon Post Acute Solutions A proud member of the Elevance Health family of companies, **Carelon Post Acute Solutions** , ... focused on transforming how healthcare is delivered and promoting the advancement of care for the people we serve. Candidates** **Must live in within a reasonable… more
- Aveanna Healthcare (Vancouver, WA)
- …enhance the level of clinical expertise of staff to provide safe and quality nursing care for our patients + Review physicians' orders and update the plans of ... Healthcare is one of the nation's largest home health care companies in the United States and growing! We... Case Manager: + Must have good standing license ( RN ) in the state in which the clinician… more