• UM Case Manager

    Healthfirst (WA)
    … management, identifying alternative care options, and discharge planning** + **Certified Case Manager ** + **Interqual and//or Milliman knowledge** + **Knowledge ... This position is 100% Remote** **Duties//Responsibilities:** + **Provides case management services for assigned member caseloads which includes:** +… more
    Healthfirst (10/07/25)
    - Related Jobs
  • Pharmacist, Utilization Management ( UM

    Molina Healthcare (WA)
    …medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist, UM will be responsible for reviewing coverage determinations and ... in a timely, compliant, and accurate manner. The Pharmacist, UM will also be responsible for serving as a...changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary… more
    Molina Healthcare (09/25/25)
    - Related Jobs
  • RN, Care Manager

    Whidbey General Hospital (Coupeville, WA)
    …+ Washington State DOH RN License required. + Current BLS HCP required. + Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. ... home health, Hospice, skilled nursing, anti-biotic regime, etc. The RN - Care Manager follows the hospital's Case Management/Utilization Plan that integrates the… more
    Whidbey General Hospital (10/01/25)
    - Related Jobs
  • RN Auditor, Clinical Services remote based in

    Molina Healthcare (Spokane, WA)
    …Clinical Services Auditor performs auditing of clinical staff in Utilization Management ( UM ), Case Management (CM), Member Assessment Team (MAT), Health ... auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case Management (CM), Member Assessment Team (MAT), Health Management… more
    Molina Healthcare (10/09/25)
    - Related Jobs
  • Transplant Care Nurse - Remote

    Highmark Health (Olympia, WA)
    …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
    Highmark Health (10/10/25)
    - Related Jobs