- Swedish Health Services (Seattle, WA)
- …be considered_** **Care Manager RN ** **Per diem / On call** **Day shift** The Utilization Review (UR) Nurse has a strong clinical background blended with ... a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination....(BSN) from an accredited school of nursing. + Washington Registered Nurse License upon hire. + 3… more
- Humana (Olympia, WA)
- …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... Previous experience in utilization management and/or utilization review . + Minimum of two (2) years of proven experience in management or leadership role. +… more
- Humana (Olympia, WA)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- Molina Healthcare (Vancouver, WA)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
- Molina Healthcare (WA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (Bellevue, WA)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- Whidbey General Hospital (Coupeville, WA)
- …background to assure compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning. The RN - Care Manager will lead an ... an RN + Minimum of two years current experience as an RN in utilization review , case management and/or discharge planning in a hospital inpatient acute… more
- CVS Health (WA)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- PeaceHealth (Vancouver, WA)
- …have equivalent combination of education and/or experience) Credentials + Required: WA State Registered Nurse License + Required Upon Hire: Provider Basic Life ... teach. (Required) + Knowledge of discharge planning, health care reimbursement, utilization review processes and Medicare admission status/classification level.… more
- CVS Health (Olympia, WA)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join...experience in Nursing. + At least 1 year of Utilization Management experience in concurrent review or… more