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Utilization review nurse jobs in Seattle, WA

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  • Case Manager Liaison Nurse - Outpatient - Complex Case Management 1.0 FTE Capitol Hill/Seattle

    Kaiser Permanente 4.7company rating

    Utilization review nurse job in Seattle, WA

    Description: CASE MANAGER LIAISON NURSE - OUTPATIENT - COMPLEX CASE MANAGEMENT ONSITE (3) DAYS - REMOTE (2) DAYS PER WEEK (MON & WED) - CAPITOL HILL/SEATTLE WA 5/8-S - MONDAY THROUGH FRIDAY - 8:00 AM - 4:30 PM Job Summary: The Care Manager will work in two settings on a periodic rotating schedule, planningthe discharges and follow up care for Kaiser Foundation Health Plan of Washington patients hospitalized at a nearby network facility and carrying a case load of patients in one of the Kaiser Foundation Health Plan of Washington medical centers. Some weekends and holidays are required, and scheduled days of the week are variable. Primary responsibility is to focus on achievement of optimal patient health care outcomes while ensuring appropriate utilization of health care resources. Working closely with primary care teams, specialty care teams and medical providers, the Liaison Nurse will establish a collaborative plan of care to assure adherence to the medical plan, improvement in functional status, and improved ability to self-manage. Serves as the liaison across the internal KFHPW care continuum and between KFHPW and all externally contracted providers, facilities, and resources and provides feedback to the organization regarding the service and quality of contracted services. The Liaison Nurse collects data and provides input to leadership regarding issues or concerns related to utilization, cost, quality, service and care delivery to patients. Essential Responsibilities: Ensures patients referred to case management meet established case management criteria. Assess all patients referred for case management to determine physical, mental, financial, psychosocial status, utilizing comprehensive, standardized criteria to identify existing and potential needs. Develop patient centered case management plan based on assessments and including patient goals, objectives, and outcomes with specific time frames (long/short term). Evaluate ability and availability of designated caregiver(s) to provide patient support. Coordinate and implement interventions using evidence based guidelines. Recommend additional services to PCP as determined in the case management plan. Conduct ongoing assessment of progress against original goals. Continuously update needed services. Maintain ongoing communication with patient/family and care team. Acts as an advocate for patient care needs. Documents all responses of patient to case management interventions. Collaborates with other health care professionals regarding the plan of care, variances in plan implementation, achieved outcomes or expected outcomes. Monitor and evaluate short and long term patient responses to therapeutic interventions and analyze patterns of variance from clinical information and outcomes. Recommend alternative settings for care based on health care needs and appropriate utilization of health care resources. Document interventions and interactions with patients or caregivers according to KFHPW and Care Management policy and procedure. Participate in the measurement of the effectiveness of the case management program. Directs and guides the plan of care to result in a seamless continuum of care. Facilitates as needed, referrals for home health care, long term care, hospice, and other care facilities or services. Participation in care conferences to provide problem solving for patients with complex care needs (limited basis). Collects needed data needed to evaluate the effects of care coordination on quality outcomes, fiscal parameters, patient satisfaction and systems improvement. Understands and utilizes health plan requirements and patient benefits in making care management decisions. Assists patient to understand and comply with their medical treatment plan. Supports patient education and activation through referral to specific chronic illness classes, group visits or community resources. Basic Qualifications: Experience Minimum three (3) years of recent RN medical/surgical/ambulatory clinical experience required. Minimum two (2) years of RN experience in ambulatory case management, care coordination or disease management. Education Bachelors degree License, Certification, Registration Registered Nurse License (Washington) required at hire OR Compact License: Registered Nurse required at hire Basic Life Support required at hire Case Manager Certificate within 36 months of hire Additional Requirements: Effective, independent nursing judgment and skills, and use of evidence based clinical decision making criteria. Knowledge in management of chronic disease process, nursing process and collaborative care planning. Demonstrated skill and experience in effectively collaborating with care team members. Preferred Qualifications: Minimum two (2) years of RN experience in utilization review, ambulatory case management, care coordination or disease management. Bachelors of science in nursing.
    $67k-83k yearly est. 11d ago
  • Labor and Delivery - LD RN - Travel Nurse

    Travel Nurse Across America 4.5company rating

    Utilization review nurse job in Auburn, WA

    We're looking for Labor and Delivery RNs for an immediate travel nurse opening in Auburn, WA. The right RN should have 3 years' recent acute care experience. Read below for more requirements. L&D Travel Nurses provide care and support for women before, during and after delivery of a baby. L&D RNs must ensure that the medical as well as emotional needs of their patients are met at all times throughout the birthing process. As an L&D RN, you'll be responsible for assisting physicians when epidurals or pain medications are administered, episiotomies are performed, or when the patient requires preparation for a cesarean delivery. As an L&D Travel Nurse, you should be prepared to perform the following tasks: Stay with and monitor patient throughout labor. Monitor contractions and help patients with breathing techniques. Check cervix periodically to monitor progression/lack of dilation. Ensure beds are kept clean and dry; clean up bodily fluids expelled before and after birthing process. Aid physician with drapes, gloves, gowns, delivery instruments, etc. Immediate care of newborn. L&D Travel Nurses should be able to stand and walk for long periods of time, as well as bend, lean and stoop without difficulty. RNs should be able to easily lift 20 pounds. Moving or lifting of patients may require lifting of up to 50 pounds at times. Because of the fast-paced environment, L&D RNs must possess good skills for coping with stress and be able to relate to people of all ages and backgrounds. Requirements*: BLS, NRP, EFM, 3 Years * Additional certifications may be required before beginning an assignment.
    $93k-142k yearly est. 20h ago
  • Telephonic Nurse Case Manager II

    Carebridge 3.8company rating

    Utilization review nurse job in Seattle, WA

    Sign on Bonus: $2000. Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Preferred locations: Seattle, WA, Denver, CO, Las Vegas, NV or Woodland Hills, CA or Costa Mesa, CA. "Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law." Hours: Monday - Friday 9:00am to 5:30pm with 1-2 late evenings 11:30am to 8:00pm depending on your time zone. * This position will service members in different states; therefore, Multi-State Licensure will be required. The Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. How you will make an impact: * Ensures member access to services appropriate to their health needs. * Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. * Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. * Coordinates internal and external resources to meet identified needs. * Monitors and evaluates effectiveness of the care management plan and modifies as necessary. * Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. * Negotiates rates of reimbursement, as applicable. * Assists in problem solving with providers, claims or service issues. * Assists with development of utilization/care management policies and procedures. Minimum Requirements: * Requires BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * Current, unrestricted RN license in applicable state(s) required. * Multi-state licensure is required if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences: * Case Management experience is preferred. * Certification as a Case Manager is preferred. * Minimum 2 years' experience in acute care setting is preferred. * Managed Care experience is preferred. * Ability to talk and type at the same time is preferred. * Demonstrate critical thinking skills when interacting with members is preferred. * Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly is preferred. * Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $76,944 to $126,408. Locations: Colorado; Nevada; Washington State; California. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $76.9k-126.4k yearly Auto-Apply 60d+ ago
  • Telephonic Nurse Case Manager II

    Elevance Health

    Utilization review nurse job in Seattle, WA

    **Sign on Bonus: $2000.** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Preferred locations: Seattle, WA, Denver, CO, Las Vegas, NV or Woodland Hills, CA or Costa Mesa, CA.** **Alternate locations may be considered** **if candidates** **reside** **within a commuting distance from an office.** **_Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law._** **Hours: Monday - Friday 9:00am to 5:30pm with 1-2 late evenings 11:30am to 8:00pm depending on your time zone.** *******This position will service members in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. **How you will make an impact:** + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. + Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. + Coordinates internal and external resources to meet identified needs. + Monitors and evaluates effectiveness of the care management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. + Negotiates rates of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of utilization/care management policies and procedures. **Minimum Requirements:** + Requires BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. + Current, unrestricted RN license in applicable state(s) required. + Multi-state licensure is required if this individual is providing services in multiple states. **Preferred Capabilities, Skills and Experiences:** + Case Management experience is preferred. + Certification as a Case Manager is preferred. + Minimum 2 years' experience in acute care setting is preferred. + Managed Care experience is preferred. + Ability to talk and type at the same time is preferred. + Demonstrate critical thinking skills when interacting with members is preferred. + Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly is preferred. + Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $76,944 to $126,408. Locations: Colorado; Nevada; Washington State; California. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $76.9k-126.4k yearly 60d+ ago
  • Utilization Management Coordinator I

    CHPW

    Utilization review nurse job in Seattle, WA

    **This role is remote in Washington State only** Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. About the Role The level I UM Coordinator is responsible for administrative functions in processing Utilization Management (UM) organization determinations for services requiring authorization and hospital notification. Utilizing knowledge of Medicare and Medicaid guidelines to facilitate and comply with the UM processes in data entry of authorization requests, eligibility verification, benefit determinations, timely letter fulfilment, and support to UM clinical staff. To be successful in this role, you: Have an associate degree, or an equivalent combination of education and highly relevant experience. Have at least one (1) year of customer service experience, preferred. Have working experience in a Healthcare setting, preferred. Have working experience in a Managed Care setting, preferred. Are knowledgeable of medical terminology and healthcare processes, preferred. Are knowledgeable of Washington Apple Health and Medicare Advantage Plans, preferred. Essential functions and Roles and Responsibilities: Performs data entry for all referral, prior authorizations and hospital notifications; attaches and/or includes clinical documents as needed. Utilizes knowledge to determine appropriate CPT, HCPC, ICD-10 codes using CMS, NCQA and HCA criteria. Researches and validates benefit and prior authorization requirements to determine appropriate course of action within the Care Management system. Reviews, corrects, and approves authorization requests via the web portal; determines appropriate level of complexity and refers cases requiring clinical review to a nurse reviewer. Reviews completed denial letters for accuracy and adherence to compliance deadlines. Edits and proofreads content for appropriate medical terminology and MCG criteria. Ensures letters are mailed within established timeframes. Accurately applies policies & procedures, benefit and eligibility standards to all incoming requests. Conducts research, validates data, and responds to complex inquiries from multiple sources, including but not limited to members, nurses, medical providers, customer service, operations, appeals, case management and care coordination. Escalating issues as needed. Reporting to work on time and for all scheduled shifts is essential to this position. Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion. Knowledge, Skills, and Abilities: Solid analytical skills and the ability to interpret, evaluate and formulate action plans based upon data. Knowledge of care management workflow systems. Effective verbal and written communication skills. Able to communicate with and collaborate effectively with physicians and allied health care providers. Flexibility and willingness to work in a matrix-management environment. Demonstrated organizational, time management, and project management skills. Ability to multi-task and deal with complex assignments on a frequent basis. Demonstrated proficiency and experience with Microsoft Office products. Ability to work independently. Collaborate with others in a respectful manner and ability to maintain confidentiality. Perform all functions of the job with accuracy, attention to detail and within established timeframes. As part of our hiring process, the following criteria must be met: Complete and successfully pass a criminal background check Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant's criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees. Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency Vaccination requirement (CHPW offers a process for medical or religious exemptions) Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. Compensation and Benefits: The position is FLSA Non-Exempt and is eligible for overtime. Based on market data, this position grade is 37 (see full range below) and has a 5% annual incentive target based on company, department, and individual performance goals. The starting salary for this role is $21.00-$22.50 an hour. CHPW offers the following benefits for Full and Part-time employees and their dependents: Medical, Prescription, Dental, and Vision Telehealth app Flexible Spending Accounts, Health Savings Accounts Basic Life AD&D, Short and Long-Term Disability Voluntary Life, Critical Care, and Long-Term Care Insurance 401(k) Retirement and generous employer match Employee Assistance Program and Mental Fitness app Financial Coaching, Identity Theft Protection Time off including PTO accrual starting at 17 days per year. 40 hours Community Service volunteer time 10 standard holidays, 2 floating holidays Compassion time off, jury duty Sensory/Physical/Mental Requirements: Sensory*: Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance. Physical*: Extended periods of sitting, computer use, talking and possibly standing. Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion. Frequent torso/back static position; occasional stooping, bending, and twisting. Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching. Mental: Frequent decision-making. Ability to gather and assess data, determine appropriate actions, apply protocols and knowledge to unique situations, problem-solve and provide consultation. Work Environment: Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation. *Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. *The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities, or requirements of this position. Job descriptions may be updated or changed to reflect business needs.
    $21-22.5 hourly 7d ago
  • Regional Nurse Consultant (RN)

    Radiant Medical Staffing

    Utilization review nurse job in Seattle, WA

    Regional Director of Clinical Operations New role to support Clinical Quality with a growing company! Full Time/40 hours Salary Range: $150,000 - $170,000k (DOE) Regional Travel is required in Western WA State Additional Information: Katie Kettlety, Sr Executive Recruiterkkettlety@radianmedstaff.com OVERVIEW: The Regional Nurse is a key clinical leader responsible for supporting multiple skilled nursing facilities within a designated region. This role exists to ensure consistency in care quality, regulatory alignment, and clinical standards across locations. By serving as a central clinical resource and advisor, the Regional Nurse helps strengthen facility performance, enhance resident outcomes, and uphold the organization's commitment to excellence. JOB SUMMARY: The Regional Nurse provides hands-on clinical support, oversight, and leadership to facility nursing teams. This includes conducting routine site visits, reviewing clinical practices, coaching clinical leaders, assisting with regulatory preparation, and implementing improvement initiatives. The position plays a critical role in identifying challenges, guiding corrective actions, promoting staff development, and ensuring each facility operates effectively and in compliance with all clinical requirements. RESPONSIBILITIES: Engage and assist in management of survey process Reviews medical and other pertinent records to determine compliance with standards of practice and regulations Provides further education, training and guidance as needed Regularly observes nursing practices for compliance with standards of nursing practice and federal, state and local regulations Prepares reports of findings, recommendations and assists with quality improvements Provides information and guidance in the development of policies and standards of nursing practice for new programs Observes that residents are provided with a comfortable, clean, orderly and safe environment A Regional Nurse Consultant may be required to assume the role of interim DON, as needed Available as needed for emergencies that supervisory personnel cannot handle Follows up on completion of Dietary Consultant Reports, Pharmacy Consultation Reports and other facility consultant reports for appropriate and timely action by facility Follows up with DON and Administrator on Quality Assurance recommendations Other Duties as Assigned REQUIREMENTS: Current RN license Preferred experience as a Director of Nursing at a Skilled Nursing Facility Experience as a Regional / Clinical Skilled Nursing RN Consultant is preferred Regulatory knowledge Experience in geriatrics is a plus
    $65k-97k yearly est. 4d ago
  • Liaison Nurse

    KP Industries, Inc. 3.7company rating

    Utilization review nurse job in Seattle, WA

    Liaison Nurse(Job Number: 1392376) Description CASE MANAGER LIAISON NURSE - OUTPATIENT - COMPLEX CASE MANAGEMENT 40 HRS/WEEK - 4/10'S - MON/WED/THURS/FRI - 7:30AM - 6PM ONSITE (3) DAYS - REMOTE (1) DAY PER WEEK - NORTHGATE CLINIC - WAJob Summary:The Care Manager will work in two settings on a periodic rotating schedule, planning the discharges and follow up care for Kaiser Foundation Health Plan of Washington patients hospitalized at a nearby network facility and carrying a case load of patients in one of the Kaiser Foundation Health Plan of Washington medical centers. Some weekends and holidays are required, and scheduled days of the week are variable. Primary responsibility is to focus on achievement of optimal patient health care outcomes while ensuring appropriate utilization of health care resources. Working closely with primary care teams, specialty care teams and medical providers, the Liaison Nurse will establish a collaborative plan of care to assure adherence to the medical plan, improvement in functional status, and improved ability to self-manage. Serves as the liaison across the internal KFHPW care continuum and between KFHPW and all externally contracted providers, facilities, and resources and provides feedback to the organization regarding the service and quality of contracted services. The Liaison Nurse collects data and provides input to leadership regarding issues or concerns related to utilization, cost, quality, service and care delivery to patients.Essential Responsibilities:Ensures patients referred to case management meet established case management criteria. Assess all patients referred for case management to determine physical, mental, financial, psychosocial status, utilizing comprehensive, standardized criteria to identify existing and potential needs. Develop patient centered case management plan based on assessments and including patient goals, objectives, and outcomes with specific time frames (long/short term). Evaluate ability and availability of designated caregiver(s) to provide patient support. Coordinate and implement interventions using evidence based guidelines. Recommend additional services to PCP as determined in the case management plan. Conduct ongoing assessment of progress against original goals. Continuously update needed services. Maintain ongoing communication with patient/family and care team. Acts as an advocate for patient care needs. Documents all responses of patient to case management interventions.Collaborates with other health care professionals regarding the plan of care, variances in plan implementation, achieved outcomes or expected outcomes. Monitor and evaluate short and long term patient responses to therapeutic interventions and analyze patterns of variance from clinical information and outcomes. Recommend alternative settings for care based on health care needs and appropriate utilization of health care resources. Document interventions and interactions with patients or caregivers according to KFHPW and Care Management policy and procedure. Participate in the measurement of the effectiveness of the case management program.Directs and guides the plan of care to result in a seamless continuum of care. Facilitates as needed, referrals for home health care, long term care, hospice, and other care facilities or services. Participation in care conferences to provide problem solving for patients with complex care needs (limited basis). Collects needed data needed to evaluate the effects of care coordination on quality outcomes, fiscal parameters, patient satisfaction and systems improvement. Understands and utilizes health plan requirements and patient benefits in making care management decisions. Assists patient to understand and comply with their medical treatment plan. Supports patient education and activation through referral to specific chronic illness classes, group visits or community resources.Qualifications Basic Qualifications: Experience Minimum three (3) years of recent RN medical/surgical/ambulatory clinical experience required.Minimum two (2) years of RN experience in ambulatory case management, care coordination or disease management. Education Bachelors degree License, Certification, Registration Registered Nurse License (Washington) required at hire OR Compact License: Registered Nurse required at hire Basic Life Support required at hire Case Manager Certificate within 36 months of hire Additional Requirements: Effective, independent nursing judgment and skills, and use of evidence based clinical decision making criteria.Knowledge in management of chronic disease process, nursing process and collaborative care planning.Demonstrated skill and experience in effectively collaborating with care team members. Preferred Qualifications: Minimum two (2) years of RN experience in utilization review, ambulatory case management, care coordination or disease management.Bachelors of science in nursing.
    $70k-90k yearly est. Auto-Apply 2d ago
  • Nursing - Case Manager

    MLK 4.2company rating

    Utilization review nurse job in Seattle, WA

    Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************
    $62k-74k yearly est. 9d ago
  • NURSE CARE COORDINATOR

    University of Washington 4.4company rating

    Utilization review nurse job in Seattle, WA

    UW Medical Center - Montlake's Social Work and Care Coordination department has an outstanding opportunity for a Nurse Care Coordinator to join our team, with the goal of achieving coordinated patient flow through an inpatient stay, culminating in a safe and timely discharge. This position works closely with all members of the interdisciplinary health care team. ensuring that the team is aware of the patient's plan of care and that all disciplines are working toward the same goals for the patient. WORK SCHEDULE * Per Diem/Intermittent * Variable Shifts * Days PRIMARY JOB RESPONSIBILITIES * Identification and monitoring of high medical needs patients to ensure timely completion of consults, procedures and tests, ongoing team communication, and facilitates coordination between providers across the continuum of care. * Lead medical team and nursing huddles and work creatively on removing barriers to discharge due to medical complications and/or system or team obstacles. * Assist with ordering complex medical equipment and in ensuring safe transitions of care. * Develop and monitor outcome measures related to care coordination and staff and patient satisfaction with discharge planning and providing ongoing consultation and education to staff on how to achieve improved patient flow through the UWMC system. REQUIREMENTS * Master's degree in Nursing or related field. Applicable experience may substitute for education. * Three years of professional nursing experience. * Experience in Case Management. * Able to communicate effectively in English, both verbally and in writing. * Effective interpersonal skills, leadership skills, and clinical expertise. * Ability to access information and document in electronic medical record. * Current Washington State RN licensure at time of hire, and current BLS. ABOUT UW MEDICAL CENTER-MONTLAKE The UW Medical Center-Montlake campus is located on the edge of the beautiful UW campus which includes many amenities available to our staff as well as very convenient public transit options including the Sound Transit's light rail station across the street. UW Medical Center is an acute care academic medical center located in Seattle with two campuses: Montlake and Northwest. As the No. 1 hospital in Seattle and Washington State since 2012 (U.S. News & World Report) and nationally ranked in seven specialties, UW Medical Center prides itself on compassionate patient care as well as its pioneering medical advances. ABOUT UW MEDICINE - WHERE YOUR IMPACT GOES FURTHER UW Medicine is Washington's only health system that includes a top-rated medical school and an internationally recognized research center. UW Medicine's mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow's physicians, scientists and other health professionals. All across UW Medicine, our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful, welcoming environment where every patient, family, student and colleague is valued and honored. Nearly 29,000 healthcare professionals, researchers, and educators work in the UW Medicine family of organizations that includes: Harborview Medical Center, UW Medical Center - Montlake, UW Medical Center - Northwest, Valley Medical Center, UW Medicine Primary Care, UW Physicians, UW School of Medicine, and Airlift Northwest. Join our mission to make life healthier for everyone in our community. Compensation, Benefits and Position Details Pay Range Minimum: $43.82 hourly Pay Range Maximum: $79.60 hourly Other Compensation: $4.50/hr Night Shift $4.00/hr Weekend Shift $2.50/hr Evening Shift $1.00/hr BSN $1.25/hr Nursing Certification Benefits: For information about benefits for this position, visit **************************************************************************************** Shift: First Shift (United States of America) Temporary or Regular? This is a temporary position FTE (Full-Time Equivalent): 0.00% Union/Bargaining Unit: WSNA UWMC Montlake About the UW Working at the University of Washington provides a unique opportunity to change lives - on our campuses, in our state and around the world. UW employees bring their boundless energy, creative problem-solving skills and dedication to building stronger minds and a healthier world. In return, they enjoy outstanding benefits, opportunities for professional growth and the chance to work in an environment known for its diversity, intellectual excitement, artistic pursuits and natural beauty. Our Commitment The University of Washington is committed to fostering an inclusive, respectful and welcoming community for all. As an equal opportunity employer, the University considers applicants for employment without regard to race, color, creed, religion, national origin, citizenship, sex, pregnancy, age, marital status, sexual orientation, gender identity or expression, genetic information, disability, or veteran status consistent with UW Executive Order No. 81. To request disability accommodation in the application process, contact the Disability Services Office at ************ or **********. Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.
    $43.8-79.6 hourly 52d ago
  • Field Nurse (LPN)

    Concertocare

    Utilization review nurse job in Tacoma, WA

    Licensed Practical Nurse Sign on bonus eligible! Yearly continuing education allowance Opportunity to enroll in Medical, Dental, Vision and 401k Competitive salary and bonus program 15 days of PTO subject to Company policy 11 paid holidays yearly subject to Company policy Grow a relationship with your patients Work in your community Proprietary technological systems Our Mission: At ConcertoCare, we believe seniors and older adults with complex care needs deserve a more holistic, equitable, and compassionate approach to health and wellness. ConcertoCare's tech-enabled in-home care teams leverage our value-based, interdisciplinary care model to address unmet health and social needs and improve patients' quality of life, partnering with them, their caregivers, families, health providers, and communities Our Vision: We will redefine care and aging for millions of US seniors and other adults with complex care needs by perfecting the kind of human-first, tech-enabled care in the home that we would want for our families. ConcertoCare is seeking a Licensed Practical Nurse (LPN) to be a core member of a multi-disciplinary Field Team that delivers home- and community-based care to patients with complex needs. This is a great fit for a Licensed Practical Nurse (LPN) who is seeking: An opportunity for “top of license” clinical practice. A collaborative multidisciplinary team-based approach to care. An innovative, value-based clinical model focused on caring for patients with complex needs who are inadequately served by traditional healthcare delivery systems. Access to professional development via dedicated clinical education programming and real-time support from our on-staff world-class experts in geriatric medicine, palliative care, geriatric psychiatry, clinical pharmacy, care management, and social determinants of health and health equity. Responsibilities: Partners with team members in the development and implementation of clinical treatment plans under the clinical supervision of providers and registered nurses and the direction of team members; includes active engagement and participation in all team meetings. Supports wrap-around clinical services in the home- and field setting, including delivery of care through co-visits with other team members, assisted telehealth visits with providers and other team members, and independent LPN visits. Provides clinical services and clinical coordination services as directed by a patient's clinical risk assessment and clinical care plan and under the clinical supervision of providers, Practice Manager, and RN Case Managers. Conducts health screenings for newly enrolled patients and on an ongoing basis. Performs clinical services in the field, including but not limited to wound care dressing changes, phlebotomy, medication review, and patient status checks. Meets with unable-to-reach patients in their home setting to re-engage patients in the program. Provides cross-coverage for planned and unplanned absences for team members to ensure that patient care is not interrupted. Partners with interdisciplinary team members to continuously improve the quality of care, reduce the cost of care, and improve both patient and staff satisfaction. Requirements Licensed Practice Nurse, license certification in the state of employment Experience providing care for the whole person, including patients living with mental illness and substance use disorders. Current CPR and BLS certification required Average to advanced computer & software skills (Microsoft Word, Excel, Outlook) Ability and means to travel as needed in a timely manner to locations that may have limited access to public transportation; proof of liability and property damage insurance on vehicle used is required. DRIVER REQUIREMENTS: Licensed for a minimum of 5 years. No vehicle-related suspensions, DUI, reckless driving, leaving the scene of an accident, vehicular manslaughter, felony convictions, or 3 or more moving violations within the last 5 years. No more than 2 moving violations or 1 at-fault accident in the last 3 years. n Policy ConcertoCare requires all “frontline workers” to be fully vaccinated and to provide records for validation. Medical or religious exemptions will be considered contingent upon the review of appropriate documentation. Base Salary/ Wage Range $3.00 - $42.00/hour with annual bonus. Compensation for the role is commensurate with the candidate's qualifications, skills, competencies, and experience and may fall outside of the range shown. ConcertoCare offers a competitive total rewards package, which includes full healthcare coverage, a 401K with match, and a broad range of other health, wellness, and financial benefits. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. ConcertoCare is an Alcohol/Drug/Smoke-Free Workplace
    $80k-128k yearly est. 8d ago
  • Wellness Nurse (WA)

    Aegis Living 3.8company rating

    Utilization review nurse job in Seattle, WA

    Wellness Nurse Hiring Now! Aegis Living is looking for a Nurse to provide quality care to our residents. Are you looking for consistent hours? Looking to get out of the fast-paced environment of hospitals? Want the ability to grow your career to management a position? We will give our Nurses set schedules with the option of flexibility, a focus on being a clinical expert on the floor, and a clear career growth path. The Wellness Nurse is an integral member of our nursing team, contributing health care expertise to promote an environment of optimal living for our residents. Our Nurses will provide clinical expertise to our senior residents with ongoing assessments and monitoring the health and wellbeing of our residents. Aegis Living is an Assisted Living and Memory Care community in Seattle. Our nurses are supported by a team of Caregivers, Medication Technicians, and our Health Services Director. Schedule: Overnight What We Offer: Defined Growth Opportunities in Nursing Leadership 401k Flexible Schedules PTO (paid time off) + Sick Pay +Appreciation Days Tuition Assistance Program Medical/ Dental/ Vision Discounted Meals Free Parking Responsibilities What You Will Do: Wound care Medication Management Provide nursing services to residents Communication with families and physicians Conduct fall risk assessments, skin assessments, pain assessments, Fast Scale assessments Hands-on nursing care Coordinate resident care with residents, families, and physicians Communicate care plan changes to staff Audit eMARS, med cart Participate in training of care staff Qualifications Who You Are: RN/ LPN License that is active and in good standing A passion to work with our amazing seniors! Outstanding communication skills Ability to work hard, support your team and build fun into the job Must be willing to take 2-step TB test Who We Are: Aegis Living is a national leader in retirement, assisted living and memory care; providing the finest in senior lifestyle emphasizing health, quality of life, well-being, and community. What Next? Apply ONLINE OR Come visit us today Min Salary USD $40.00/Hr. Max Salary USD $45.00/Hr.
    $40-45 hourly Auto-Apply 60d+ ago
  • Substitute Nurse 2025-2026

    Lake Washington School District 4.8company rating

    Utilization review nurse job in Redmond, WA

    Substitute Staff (Non-Teaching)/Other Additional Information: Show/Hide Lake Washington School District is looking for qualified Registered Nurses to work as Substitute Nurses on an as needed basis for the 2025-2026 school year. Work shift and schedule will vary based on the assignment. Substitute Nurses will fill in for regularly scheduled employees during absences and leaves and hours can be up to 40 hours per week. Initial need is for an extended 4-6 week leave and a full time leave from beginning of school year through January 2026. JOB PURPOSE STATEMENT Provides nursing and school-related health care needs for students, parents and staff. Supervise; delegate care for medically fragile school age children. Ensures delivery of appropriate health care services and a safe school environment. Performs screening programs with the assistance of parent volunteers and makes appropriate follow-up referrals. Perform state mandated immunization programs. Assists in the development and implementation of health education curriculum. Work with and delegate to Para Educator nursing procedures. Hourly rate: $45.50 per hour. This is a non-benefited position. Qualified Candidates will be contacted by the Special Services Deptartment if selected for an interview. LICENSE/SPECIAL REQUIREMENTS: • Valid Washington State Registered Nursing License. • First aid- and CPR certification preferred. • Valid Washington State driver's license. • Hepatitis B immunization. Education and Experience: * Bachelor's degree in nursing or an associate degree in nursing or a nursing diploma earned in an accredited hospital program and job-related experience. * Five years of nursing experience desired. APPLICATION PROCEDURE: External and Internal Applicants: Submit an online application @ ****************************** and apply to this posting. FINALISTS WILL BE CONTACTED FOR AN INTERVIEW. Please review LWSD Human Resources Employment Policies, which includes our non-discrimination policy. We are not able to sponsor employment at this time. Lake Washington School District is committed to building an inclusive, equitable, and welcoming environment for all students and staff. We welcome candidates from all backgrounds and life experiences who share our commitment to educational excellence and equity. We especially encourage applications from individuals who have been historically underrepresented in education. LAKE WASHINGTON SCHOOL DISTRICT IS A SMOKE-FREE WORKPLACE. Attachment(s): * School Nurse 2024 (1).pdf
    $45.5 hourly 60d+ ago
  • NOC On-Call Admissions Nurse - Full Time/Exempt

    Alpha Home Health and Hospice 3.6company rating

    Utilization review nurse job in Everett, WA

    Alpha Home Health and Hospice is a Medicare-certified agency serving seeking someone just as passionate as we are about providing quality patient services to join our team as a Full Time Hospice NOC On-Call Admissions Nurse (RN). Job Details: Status: Full Time Location: TBD Wage Range: $115,000 - $117,000 Annual Salary This role is a 7 on/7 off shift, 5 pm to 8 am. Job Duties & Responsibilities: Performs comprehensive nursing evaluations. Assesses for signs and symptoms of discomfort including presence of pain and takes prompt and appropriate action. Initiates and manages plan of care, provides appropriate nursing follow -up to all patients, and instructs caregivers in managing patient needs. Coordinates all services provided to patients and families, as well as appropriateness of care, to ensure quality of care and services. Maintains the implementation of the approved plan of care, modifies as needed, and contacts Physician, Medical Director and Hospice Team when appropriate. Demonstrates flexibility in scheduling, and readily accepts new admissions and emergency assignments as requested. Maintains knowledge of state and federal regulations and The Joint Commission standards. Participates in the Quality Assurance Performance Incentive Program. Observes for safety hazards in the patient's and organization's environments and takes appropriate steps to reduce or eliminate them. Maintains continuing education through academic studies, seminars, and workshops. Attends and participates in in-services, staff meetings, and patient care conferences as required by the DPCS and Executive Director. Must be available for on-call shifts as required by the DPCS and Executive Director. Completes all documentation in an accurate and legible manner. Complies with hospice policies and procedures, laws and regulations and standards or practice. Performs other duties as assigned. The above statements are only meant to be a representative summary of the major duties and responsibilities performed by the employee of this job. The employee may be requested to perform job-related tasks other than those stated in this description. Job Requirements? Education: Graduate of an accredited school of nursing. Credentials: Current RN License within WA. Bachelors in Nursing preferred. Certification in Hospice and Palliative Nursing desired. A current CPR Certification, Valid Driver's License and auto insurance. Experience: Minimum of one year experience as a professional nurse within the last 3 years with strong clinical assessment skills. Skills: All nursing functions, written and oral communication skills, sympathetic attitude, customer services/relations, ability to work with dying patients, organizational and diplomacy. Supervises: Provides supervision of Home Health Aides, Licenses Vocational Nurses, Licensed Practical Nurses, and Homemakers to ensure the best quality of care for patients. What we offer you: A choice of medical, dental, and vision plans Health concierge and Teladoc services FSA and HSA accounts Life, AD&D, STD, and LTD plans PTO Paid holidays Employee Assistance Program 401K with company match Company-wide celebrations of your great work & accomplishments Support for your professional growth and development Tuition reimbursement AMAZING teammates & leaders that are supportive, inclusive, and fun! And more! We would love to meet you and hear your commitment to living CAPLICO with us! Customer Second (Employee First) Accountability Passion For Learning Love One Another Intelligent Risk Taking Celebration Ownership To learn more about Alpha Home Health & Hospice, please visit our website at *********************************** Follow us on Facebook at @ ************************************************** LinkedIn @ *********************************************************** The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at **************************** The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at ****************************
    $115k-117k yearly Auto-Apply 60d+ ago
  • Nursing - 32677702

    Careage Home Health 3.5company rating

    Utilization review nurse job in Bellevue, WA

    Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************
    $56k-69k yearly est. 60d+ ago
  • Standardized Nursing Patient (On-call)

    Lake Washington Institute of Technology 3.9company rating

    Utilization review nurse job in Kirkland, WA

    Located just outside of Seattle, WA,Lake Washington Institute of Technology (LWTech) was founded in 1949, and is the only public institute of technology in the state of Washington. LWTech offers 12 bachelor's degrees, 42 associate degrees, and 70 professional certificates in 41 areas of study, including STEM-focused programs in Science, Technology, Engineering and Math. LWTech serves the Eastside and is located within the city of Kirkland, which is situated on the eastern shore of Lake Washington. Kirkland is home to companies such as GoDaddy, Google, Astronics and EvergreenHealth, and the college is within minutes from Microsoft and Nintendo. Learn more about LWTech's Mission, Vision, Values, and Core Themes LWTech is committed to increasing its cultural diversity with an emphasis on equity and inclusion among its staff and faculty. We serve a student population of 6,500 that come from a variety of backgrounds. We strongly value diversity and are working to improve access and successful educational outcomes for all students. We are actively seeking applicants that will help to balance our employee workforce to align with our students and community. Questions regarding the College's commitment to diversity and our campus culture may be directed to Human Resources. For more information on our Equity, Diversity, Inclusion Council, please click on the link. Summary of Responsibilities The Standardized Patient (SP) will portray patients in on-campus simulated clinical scenarios to assist nursing students in developing communication, assessment, and clinical skills. SPs will follow detailed case scripts and provide feedback to learners under faculty supervision. This recruitment is to establish a diverse applicant pool for future on-call SP vacancies. The college hires SPs on a temporary/hourly, quarter by quarter basis, dependent on enrollment and class need. If you are selected for an interview for a potential future vacancy, a college representative will contact you. * Accurately and consistently portray a patient's history, symptoms, and emotional state according to provided case materials. * Participate in simulated clinical encounters, including physical assessments (non-invasive) and communication exercises. * Wear/use simulated medical equipment and costumes (e.g., oxygen mask, nasal cannula, blood pressure cuff, patient gown, walker, crutches, wigs, glasses, etc.). * Memorize and maintain case details to ensure consistency across multiple student interactions. * Provide constructive feedback to students on communication and interpersonal skills when requested. * Maintain confidentiality of all student performance and program materials. * Attend required training sessions and adhere to program guidelines. * Signed Lake Washington Institute of Technology Standardized Patient Consent, Assumption of risk, release, and waiver of liability agreement once hired. * May not be a current employee or enrolled at Lake Washington Institute of Technology. * Strong verbal communication and interpersonal skills. * Ability to memorize and accurately recall case details. * Comfortable with role-playing and receiving direction from faculty. * Reliable and punctual; flexible schedule for on-call assignments. * No prior medical experience required (training provided). * Must be able to sit or lie down for extended periods and tolerate light physical examination (e.g., listening to heart/lungs, checking pulse, etc. no invasive procedures will be performed). * Acting or improvisation experience preferred. * Experience in healthcare simulation preferred. COMPENSATION & WORK SCHEDULE: Placement on the hourly schedule is based on an individual assessment of education and experience. This position ranges from $42 - $51 per hour. This is an on-call position so hours may vary depending on department needs. CONDITIONS OF EMPLOYMENT * Official transcripts/certifications will be required upon employment * Other conditions that may apply will be detailed upon the offer of employment * Job offers are contingent upon successful completion of background/reference checks ELIGIBILITY VERIFICATION In compliance with the Immigration and Nationality Act, proof of authorization to work in the United States will be required at the time of hire. LWTech does not currently sponsor HB-1 visas. Other conditions that may apply will be detailed upon the offer of employment. Applicants considered for positions at the College may be required to submit to a background check as a condition of employment. Adverse information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability for the position. AFFIRMATIVE ACTION STATEMENT Lake Washington Institute of Technology is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, sex, disability, age, religion, sexual orientation, gender identity, gender expression, creed, disabled veteran status, marital status or Vietnam-era veteran status in its programs and activities. Questions regarding the College's Affirmative Action Policy may be directed to the Meena Park, Executive Director of Human Resources, Affirmative Action Office/Title IX Coordinator, **************. Jeanne Clery Statement: Notice of Availability of Annual Security and Fire Safety Report: In compliance with the Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act of 1998, and as a part of the College's commitment to safety and security on campus, Lake Washington Institute of Technology(LWTech) reports the mandated information about current campus policies concerning safety and security issues, the required statistics, and other related information for the past three (3) calendar years. LWTech's Annual Safety Report (ASR) is available online at************************************ To obtain a paper copy of the report, please visit the LWTech Safety Department located in the East Building at 11605 132nd Avenue NE Kirkland, WA 98034. Pursuant to RCW 28B.112.080, applicants must declare whether they are the subject of any substantiated findings of sexual misconduct in any current or former employment or is currently being investigated for, or have left a position during an investigation into, a violation of any sexual misconduct policy at the applicant's current or past employers. By law, post-secondary education institutions cannot hire an applicant who does not complete this form. CORRECTIONS OR EXTENDED NOTICES
    $42-51 hourly 3d ago
  • Case Manager Liaison Nurse - Inpt Discharge Planning 0.6 FTE - Olympia WA (St. Peter)

    Kaiser Permanente 4.7company rating

    Utilization review nurse job in Olympia, WA

    RN CASE MANAGER LIAISON NURSE - INPATIENT DISCHARGE PLANNING - ONSITE: ST. PETER HOSPITAL - OLYMPIA ** SIGN-ON BONUS OF $5,000 APPLIESTO ELIGIBLE EXTERNAL HIRES! ** VARIABLE MON-FRI - 8AM-4:30PM - EVERY OTHER WEEKEND ROTATION - ROTATING HOLIDAYS BENEFITS ELIGIBLE POSITION! Job Summary: The Care Manager will work in two settings on a periodic rotating schedule, planning the discharges and follow up care for Kaiser Foundation Health Plan of Washington patients hospitalized at a nearby network facility and carrying a case load of patients in one of the Kaiser Foundation Health Plan of Washington medical centers. Some weekends and holidays are required, and scheduled days of the week are variable. Primary responsibility is to focus on achievement of optimal patient health care outcomes while ensuring appropriate utilization of health care resources. Working closely with primary care teams, specialty care teams and medical providers, the Liaison Nurse will establish a collaborative plan of care to assure adherence to the medical plan, improvement in functional status, and improved ability to self-manage. Serves as the liaison across the internal KFHPW care continuum and between KFHPW and all externally contracted providers, facilities, and resources and provides feedback to the organization regarding the service and quality of contracted services. The Liaison Nurse collects data and provides input to leadership regarding issues or concerns related to utilization, cost, quality, service and care delivery to patients. Essential Responsibilities: Ensures patients referred to case management meet established case management criteria. Assess all patients referred for case management to determine physical, mental, financial, psychosocial status, utilizing comprehensive, standardized criteria to identify existing and potential needs. Develop patient centered case management plan based on assessments and including patient goals, objectives, and outcomes with specific time frames (long/short term). Evaluate ability and availability of designated caregiver(s) to provide patient support. Coordinate and implement interventions using evidence based guidelines. Recommend additional services to PCP as determined in the case management plan. Conduct ongoing assessment of progress against original goals. Continuously update needed services. Maintain ongoing communication with patient/family and care team. Acts as an advocate for patient care needs. Documents all responses of patient to case management interventions. Collaborates with other health care professionals regarding the plan of care, variances in plan implementation, achieved outcomes or expected outcomes. Monitor and evaluate short and long term patient responses to therapeutic interventions and analyze patterns of variance from clinical information and outcomes. Recommend alternative settings for care based on health care needs and appropriate utilization of health care resources. Document interventions and interactions with patients or caregivers according to KFHPW and Care Management policy and procedure. Participate in the measurement of the effectiveness of the case management program. Directs and guides the plan of care to result in a seamless continuum of care. Facilitates as needed, referrals for home health care, long term care, hospice, and other care facilities or services. Participation in care conferences to provide problem solving for patients with complex care needs (limited basis). Collects needed data needed to evaluate the effects of care coordination on quality outcomes, fiscal parameters, patient satisfaction and systems improvement. Understands and utilizes health plan requirements and patient benefits in making care management decisions. Assists patient to understand and comply with their medical treatment plan. Supports patient education and activation through referral to specific chronic illness classes, group visits or community resources. Basic Qualifications: Experience Minimum three (3) years of recent RN medical/surgical/ambulatory clinical experience required. Minimum two (2) years of RN experience in ambulatory case management, care coordination or disease management. Education Bachelors degree License, Certification, Registration Registered Nurse License (Washington) required at hire OR Compact License: Registered Nurse required at hire Basic Life Support required at hire Case Manager Certificate within 36 months of hire Additional Requirements: Effective, independent nursing judgment and skills, and use of evidence based clinical decision making criteria. Knowledge in management of chronic disease process, nursing process and collaborative care planning. Demonstrated skill and experience in effectively collaborating with care team members. Preferred Qualifications: Minimum two (2) years of RN experience in utilization review, ambulatory case management, care coordination or disease management. Bachelors of science in nursing.
    $68k-83k yearly est. 11d ago
  • Telephonic Nurse Case Manager II

    Elevance Health

    Utilization review nurse job in Seattle, WA

    Sign on Bonus: $2000. Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Preferred locations: Seattle, WA, Denver, CO, Las Vegas, NV or Woodland Hills, CA or Costa Mesa, CA. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Hours: Monday - Friday 9:00am to 5:30pm with 1-2 late evenings 11:30am to 8:00pm depending on your time zone. * This position will service members in different states; therefore, Multi-State Licensure will be required. The Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. How you will make an impact: * Ensures member access to services appropriate to their health needs. * Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. * Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. * Coordinates internal and external resources to meet identified needs. * Monitors and evaluates effectiveness of the care management plan and modifies as necessary. * Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. * Negotiates rates of reimbursement, as applicable. * Assists in problem solving with providers, claims or service issues. * Assists with development of utilization/care management policies and procedures. Minimum Requirements: * Requires BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * Current, unrestricted RN license in applicable state(s) required. * Multi-state licensure is required if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences: * Case Management experience is preferred. * Certification as a Case Manager is preferred. * Minimum 2 years' experience in acute care setting is preferred. * Managed Care experience is preferred. * Ability to talk and type at the same time is preferred. * Demonstrate critical thinking skills when interacting with members is preferred. * Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly is preferred. * Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $76,944 to $126,408. Locations: Colorado; Nevada; Washington State; California. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $76.9k-126.4k yearly 4d ago
  • Clinical Hemophilia Nurse Liaison - Alaska- Paragon Healthcare

    Carebridge 3.8company rating

    Utilization review nurse job in Seattle, WA

    Be Part of an Extraordinary Team A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug therapies through our specialty pharmacies, our infusion centers, and the home setting. Title: Clinical Nurse Liaison- Paragon Ideal candidates will reside in Alaska and comfortable traveling 50% of the time between Alaska, Washington, Oregon, and California Field: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Build the Possibilities. Make an Extraordinary Impact. The Clinical Nurse Liaison- Paragon is responsible to provide patient education and continuing education programs, as well as problem solves and resolves questions and issues for referral sources and patient. How you will make an impact: Primary duties may include, but are not limited to: * Determines clinical and service needs for established and new accounts and referrals. * Effectively communicates with the referral source, branch, physician, and family to coordinate and facilitate plan of care for patients. * Markets all therapies, services, and products to referral sources. * Provides in-services and continuing education programs for hospital case managers and other referral sources and support staff. * Identifies and pulls through appropriate specialty infusion referrals and assists in maximizing revenue within local / regional market. * Partners with leadership team to communicates opportunities for relationship building and business expansion. Minimum Requirements: * Requires a minimum of 3 years of expansive work experience in a clinical environment; or any combination of education and experience which would provide an equivalent background. * Licensed Registered Nurse required. Preferred Skills, Capabilities and Experiences: * Bachelor's degree preferred. * Strongly prefer experience in the home care setting. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $78,016 to $117,024 Locations: California, Washington State In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $78k-117k yearly Auto-Apply 60d+ ago
  • Wellness Nurse (WA)

    Aegis Living 3.8company rating

    Utilization review nurse job in Seattle, WA

    Wellness Nurse Hiring Now! Aegis Living Greenwood is looking for a Nurse to provide quality care to our residents. Are you looking for consistent hours? Looking to get out of the fast-paced environment of hospitals? Want the ability to grow your career to management a position? We will give our Nurses set schedules with the option of flexibility, a focus on being a clinical expert on the floor, and a clear career growth path. The Wellness Nurse is an integral member of our nursing team, contributing health care expertise to promote an environment of optimal living for our residents. Our Nurses will provide clinical expertise to our senior residents with ongoing assessments and monitoring the health and wellbeing of our residents. Aegis Living Greenwood is an Assisted Living and Memory Care community in North Seattle. Our nurses are supported by a team of Caregivers, Medication Technicians, and our Health Services Director. Schedule: * Part-time, Sunday/Monday What We Offer: * Defined Growth Opportunities in Nursing Leadership * 401k * Flexible Schedules * PTO (paid time off) + Sick Pay +Appreciation Days * Tuition Assistance Program * Medical/ Dental/ Vision * Discounted Meals * Free Parking Responsibilities What You Will Do: * Wound care * Medication Management * Provide nursing services to residents * Communication with families and physicians * Conduct fall risk assessments, skin assessments, pain assessments, Fast Scale assessments * Hands-on nursing care * Coordinate resident care with residents, families, and physicians * Communicate care plan changes to staff * Audit eMARS, med cart * Participate in training of care staff Qualifications Who You Are: * RN/ LPN License that is active and in good standing * A passion to work with our amazing seniors! * Outstanding communication skills * Ability to work hard, support your team and build fun into the job * Must be willing to take 2-step TB test Who We Are: * Aegis Living is a national leader in retirement, assisted living and memory care; providing the finest in senior lifestyle emphasizing health, quality of life, well-being, and community. What Next? * Apply ONLINE OR Come visit us today * Address: 10000 Holman Rd NW, Seattle, WA 98177 Min Salary USD $40.00/Hr. Max Salary USD $44.00/Hr.
    $40-44 hourly Auto-Apply 3d ago
  • Nurse Case Manager - ER .75 FTE Olympia WA - NIGHTS (Bachelor's reqd)

    Kaiser Permanente 4.7company rating

    Utilization review nurse job in Olympia, WA

    Description: **SIGN-ON BONUS OF $5,000 APPLIES TO ELIGIBLE EXTERNAL HIRES!** RN CASE MANAGER LIAISON NURSE - INPATIENT DISCHARGE PLANNING - ONSITE:ST. PETERHOSPITAL - OLYMPIA VARIABLE MON-FRI-10PM-10:30AM-EVERY OTHER WEEKEND ROTATION - ALTERNATING HOLIDAYS MUST HAVE PRIOR ER OR CASE MANAGEMENT WORK EXPERIENCE - NIGHT SHIFT DIFFERENTIAL APPLIES! Job Summary: The Care Manager will work in two settings on a periodic rotating schedule, planning the discharges and follow up care for Kaiser Foundation Health Plan of Washington patients hospitalized at a nearby network facility and carrying a case load of patients in one of the Kaiser Foundation Health Plan of Washington medical centers. Some weekends and holidays are required, and scheduled days of the week are variable. Primary responsibility is to focus on achievement of optimal patient health care outcomes while ensuring appropriate utilization of health care resources. Working closely with primary care teams, specialty care teams and medical providers, the Liaison Nurse will establish a collaborative plan of care to assure adherence to the medical plan, improvement in functional status, and improved ability to self-manage. Serves as the liaison across the internal KFHPW care continuum and between KFHPW and all externally contracted providers, facilities, and resources and provides feedback to the organization regarding the service and quality of contracted services. The Liaison Nurse collects data and provides input to leadership regarding issues or concerns related to utilization, cost, quality, service and care delivery to patients. Essential Responsibilities: Ensures patients referred to case management meet established case management criteria. Assess all patients referred for case management to determine physical, mental, financial, psychosocial status, utilizing comprehensive, standardized criteria to identify existing and potential needs. Develop patient centered case management plan based on assessments and including patient goals, objectives, and outcomes with specific time frames (long/short term). Evaluate ability and availability of designated caregiver(s) to provide patient support. Coordinate and implement interventions using evidence based guidelines. Recommend additional services to PCP as determined in the case management plan. Conduct ongoing assessment of progress against original goals. Continuously update needed services. Maintain ongoing communication with patient/family and care team. Acts as an advocate for patient care needs. Documents all responses of patient to case management interventions. Collaborates with other health care professionals regarding the plan of care, variances in plan implementation, achieved outcomes or expected outcomes. Monitor and evaluate short and long term patient responses to therapeutic interventions and analyze patterns of variance from clinical information and outcomes. Recommend alternative settings for care based on health care needs and appropriate utilization of health care resources. Document interventions and interactions with patients or caregivers according to KFHPW and Care Management policy and procedure. Participate in the measurement of the effectiveness of the case management program. Directs and guides the plan of care to result in a seamless continuum of care. Facilitates as needed, referrals for home health care, long term care, hospice, and other care facilities or services. Participation in care conferences to provide problem solving for patients with complex care needs (limited basis). Collects needed data needed to evaluate the effects of care coordination on quality outcomes, fiscal parameters, patient satisfaction and systems improvement. Understands and utilizes health plan requirements and patient benefits in making care management decisions. Assists patient to understand and comply with their medical treatment plan. Supports patient education and activation through referral to specific chronic illness classes, group visits or community resources. Basic Qualifications: Experience Minimum three (3) years of recent RN medical/surgical/ambulatory clinical experience required. Minimum two (2) years of RN experience in ambulatory case management, care coordination or disease management. Education Bachelors degree License, Certification, Registration Registered Nurse License (Washington) required at hire OR Compact License: Registered Nurse required at hire Basic Life Support required at hire Case Manager Certificate within 36 months of hire Additional Requirements: Effective, independent nursing judgment and skills, and use of evidence based clinical decision making criteria. Knowledge in management of chronic disease process, nursing process and collaborative care planning. Demonstrated skill and experience in effectively collaborating with care team members. Preferred Qualifications: Minimum two (2) years of RN experience in utilization review, ambulatory case management, care coordination or disease management. Bachelors of science in nursing.
    $68k-83k yearly est. 11d ago

Learn more about utilization review nurse jobs

How much does a utilization review nurse earn in Seattle, WA?

The average utilization review nurse in Seattle, WA earns between $57,000 and $95,000 annually. This compares to the national average utilization review nurse range of $47,000 to $89,000.

Average utilization review nurse salary in Seattle, WA

$73,000

What are the biggest employers of Utilization Review Nurses in Seattle, WA?

The biggest employers of Utilization Review Nurses in Seattle, WA are:
  1. providencephotonics
  2. Mercor
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