• Case Manager, Registered Nurse…

    CVS Health (Olympia, WA)
    …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) 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
    CVS Health (07/18/25)
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  • Care Manager RN - ( Remote )

    Highmark Health (Olympia, WA)
    …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
    Highmark Health (07/12/25)
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  • Utilization Management Nurse…

    CVS Health (Olympia, WA)
    …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... remote role open to candidates with an active RN licensure in the state in which they reside....to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN… more
    CVS Health (07/23/25)
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  • LPN Care Review Clinician, Prior…

    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
    Molina Healthcare (07/27/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (WA)
    **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state of UTAH or have a compact license._ _This ... Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support,… more
    Molina Healthcare (07/20/25)
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  • RN Care Manager

    Actalent (Seattle, WA)
    …in case management and care coordination. + Experience with EPIC software. + Utilization review and appeals handling capabilities. + Discharge planning and ... Job Title: RN Care Manager | Seattle, WA Job Description...home. The clinic will provide all necessary equipment for remote work. Pay and Benefits The pay range for… more
    Actalent (07/28/25)
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  • Disease Management Nurse - Remote

    Sharecare (Olympia, WA)
    …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
    Sharecare (07/12/25)
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  • Behavioral Health Clinical Liaison

    Centene Corporation (Olympia, WA)
    …and Family Therapist (LMFT) required or Licensed Mental Health Professional (LMHP) required or RN - Registered Nurse - State Licensure and/or Compact State ... information from the Operations and Medical Management teams. Assesses and performs review of member clinical records and services related to behavioral health and… more
    Centene Corporation (07/14/25)
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  • Clinical Appeals Coordinator

    Centene Corporation (Olympia, WA)
    …nursing or case management experience. Managed care or utilization review experience preferred. **License/Certification:** LPN, LVN, or RN license. **Texas ... services in healthcare or home health settings. Managed care or utilization review experience preferred. **Licenses/Certifications:** Current state license in… more
    Centene Corporation (07/25/25)
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