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Utilization review nurse jobs in Shoreline, WA - 150 jobs

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  • Utilization Review Pharmacist

    Pharmacy Careers 4.3company rating

    Utilization review nurse job in Tacoma, WA

    Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective DUR and prepare stakeholder reports. Qualifications: PharmD with managed care, DUR, or pharmacy benefit experience. Strong Excel/data analytics background preferred. Understanding of clinical guidelines and P&T processes. Why Join Us? Join a top-tier managed care team Hybrid flexibility Strategic and data-driven focus
    $68k-80k yearly est. 60d+ ago
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  • Case Manager / Admissions Nurse (Licensed Nurse) - Martha & Mary

    Martha & Mary Health Services 3.7company rating

    Utilization review nurse job in Poulsbo, WA

    Case Manager / Admissions Nurse (RN or LPN) Location: Martha & Mary Status: Exempt | Full-Time Pay Range: $85,000 - $95,000 annually depending on applicable experience About Martha & Mary At Martha & Mary, we are called to bridge generations and enrich lives. Our team is committed to providing compassionate, coordinated, and high-quality care to those we serve. If you are a skilled nurse with a passion for care coordination, advocacy, and collaboration, we invite you to join our mission-driven organization. Position Summary The Case Manager / Admissions Nurse oversees, manages, and coordinates the care experience for residents and patients from admission through discharge. Serving as the primary point of contact for care coordination, this role ensures seamless communication across interdisciplinary teams, external providers, residents, and families. The Case Manager plays a critical role in utilization management, discharge planning, quality outcomes, and patient advocacy while also providing leadership and oversight to licensed nursing staff and NACs. This position functions as an exempt role and requires flexibility to meet the needs of residents and patients. Key Responsibilities Care Coordination & Clinical Oversight Coordinate and integrate case management and social service functions into individualized plans of care and discharge planning. Conduct medical record reviews, utilization reviews, and quality assessments from admission through discharge. Oversee direct provision of care and ensure evidence-based practices are delivered. Conduct Care Conferences, Warm Handovers, interdisciplinary rounds, and family conferences. Assist with admission assessments, orders, and paperwork per DNS direction. Coordinate admissions, discharges, transfers, and bed management with nursing leadership and admissions teams. Communicate with primary care providers, hospital partners, and external specialists throughout the resident stay. Initiate and present NOMNOC (denial) letters as appropriate. Collaboration & Communication Work closely with internal partners including Nursing Leadership, Social Work, Rehab Services, MDS, HIM, A/R, Therapists, and Operations. Collaborate with external stakeholders such as family members, hospitals, discharge planners, HMOs, physicians, home health agencies, and other providers. Serve as a resident and patient advocate, ensuring informed decision-making and family education. Utilization, Compliance & Quality Monitor RUG utilization, PDPM outcomes, and appropriate service use. Conduct reviews related to falls, wounds, medication errors, readmissions, pharmacy discrepancies, and other quality indicators. Ensure appropriate testing, timely results, and adherence to regulatory and payer requirements. Participate in weekly Case Management meetings and continuous quality improvement initiatives. Leadership & Supervision Provide day-to-day leadership, guidance, and supervision to Licensed Nurses and NACs. Participate in hiring, performance management, coaching, and employee development in alignment with organizational values. Troubleshoot care concerns, complaints, and conflicts, escalating to DNS or Operations leadership as needed. Additional Duties Perform medication destruction and disposal oversight. Assist nursing staff with care activities as needed. Perform all regular RN or LPN duties per licensure and job description. General Expectations Support and uphold Martha & Mary's mission, vision, and values. Maintain confidentiality and professionalism at all times. Demonstrate reliability, flexibility, and strong teamwork. Manage multiple priorities in a fast-paced, changing environment. Approach challenges with initiative, diplomacy, and a sense of humor. Exhibit a genuine interest in caring for the elderly and long-term care residents. Required Qualifications Education Associate Degree required Bachelor's Degree preferred Licensure Current RN or LPN license in the State of Washington (required) Experience Sub-acute care or Skilled Nursing experience preferred Knowledge, Skills & Abilities Strong knowledge of Medicare, HMO contracts, MDS, PDPM utilization, and evidence-based practices Exceptional communication and customer service skills Highly organized with strong documentation abilities Ability to collaborate effectively with interdisciplinary teams Proficiency with MS Office Suite and healthcare systems including Answers on Demand, ADP, DocSTAR, FaxCORE, and mobile technology Ability to safely use medical devices and equipment Why Join Martha & Mary? Mission-driven, values-based culture Collaborative interdisciplinary team environment Opportunity to make a meaningful impact on resident and family experiences Competitive compensation and comprehensive benefits Benefits: Martha & Mary offers fair wages, competitive benefits and supportive work environments, where we become friends and family. We invite you to apply and become a part of one of Kitsap County's largest not-for profit employers. The following benefits/compensation are offered at Martha & Mary. Paid Time Off (PTO) is accrued at varying rates depending on length of employment. Accrual rates begin at 5.32 hours per month based on a 40-hour workweek. These accruals include the required sick leave per Washington State's Paid Sick Leave Law 40% discount on child care services while working Comprehensive benefit package after 60 days to include medical, dental, vision and life insurance options for full time employees. Career advancement opportunities across multiple sites and departments 403(b) Retirement Savings Plan is available immediately upon hire 6 Paid Holidays Employee Assistance and Counseling for life's challenges outside of the workplace Cell phone, Health Club and Auto service discounts And much more Martha & Mary employee benefits and wages offered are reviewed annually and are intended to be fair, beneficial and competitive in today's market whether just entering our workforce or nearing retirement. Benefit offerings are based on employment status. Salary ranges, benefits and other compensation are subject to change. Martha & Mary is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
    $85k-95k yearly Auto-Apply 7d ago
  • Clinical Utilization Management Coordinator (UM) - $5,000 SIGN-ON BONUS

    Smokey Point Behavioral Hospital

    Utilization review nurse job in Marysville, WA

    JOIN OUR TEAM AS A CLINICAL UTILIZATION MANAGEMENT COORDINATOR! $5,000 SIGN-ON BONUS | On-Site Only Master's Degree required Your Work Matters How will you make a difference? As the Utilization Management Coordinator, you will support patients and the treatment team by ensuring continued access to appropriate levels of care, advocating for medical necessity with payers, and guiding the treatment plan through clinical collaboration and strategic review. If you're looking to make a meaningful impact in the healthcare industry and be part of a dynamic team, this role is for you. Join us in our mission to provide exceptional care to our patients and support our dedicated staff. Review clinical documentation to support continued stay authorizations. Review the treatment plan and advocate for additional services as indicated. Promote effective use of resources for patients. Ensure that patient rights are upheld. Maintain ongoing contact with the attending physician, program manager, nurse manager, and various members of the team. Collaborate with the treatment team regarding continued stay and discharge planning issues. Advocate that the patient is placed in the appropriate level of care and program. Interface with program staff to facilitate a smooth transition at the time of transfer or discharge. Your Experience Matters What we're looking for: Education : A Master's degree from an accredited college or university in social work, mental health, nursing, or a related degree is required. Experience : At least two (2) years' experience in a healthcare setting or managed care company, with experience in patient assessment, treatment planning, utilization management, and/or case management. Your Care Matters What we provide for our team: 401(k) + matching Health insurance 100% company-paid life insurance coverage up to 2x your annual salary Vision insurance Dental insurance 100% company-paid long term disability insurance Paid time off Paid Holidays Cafeteria on site + one free meal per day Employee engagement events Employee assistance program Employee recognition program Free parking What sets us apart: Career & training development opportunities Dynamic and inclusive work environment Engaged management team dedicated to your success A guiding mission and set of values that serve as both our northstar and yours, anchoring our collective purpose and aspirations Disclaimer: Benefits are subject to change at the discretion of Smokey Point Behavioral Hospital. Compensation: This is a full-time role, and the expected compensation range is $35.00 - $38.00 hourly. We're eager to engage with all qualified candidates, and consideration will be provided to experience and skill level. Join us as our Clinical Utilization Management Coordinator! Qualifications Get to know us Outstanding Care, Compassionate People, Unparalleled Service Welcome to Smokey Point Behavioral Hospital (SPBH), a premier healthcare provider in Marysville, WA, setting the gold standard for excellence in mental health and addiction treatment support. Located in Marysville, WA, SPBH offers a full continuum of care, including inpatient and outpatient psychiatric services and specialized, evidence-based programs for all patients, regardless of their ability to pay. At SPBH, the community is an integral part of our team, fostering collaboration to build an efficient, comprehensive, and seamless continuum of care. We take pride in offering dynamic, challenging, and highly rewarding positions. You'll have the opportunity to work closely with a team of experts, ensuring our patients receive personalized services that guide them toward achieving their treatment goals. Join us in providing exceptional care and contributing to the well-being of individuals and families in need, and be a part of the transformative healthcare experience at Smokey Point Behavioral Hospital. To learn more about SPBH, visit us at: ********************************************** TOGETHER WE CAN MAKE POSITIVE I.M.P.A.C.T.S. I ndividuals Maintaining Positive Attitude and Commitment To Service ____________________________________________________________ At Smokey Point Behavioral Hospital, we value a diverse, inclusive workforce and provide equal employment opportunities for all applicants and employees. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities
    $35-38 hourly 13d 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. 56d ago
  • Flight Nurse

    Life Flight Network 4.3company rating

    Utilization review nurse job in Renton, WA

    Life Flight Network is one of the most prominent not-for-profit air ambulance organizations. As the industry's trailblazers, we constantly raise the bar for safety, excellence, social justice, and innovation in the skies and on the ground. Being a member of our esteemed team means embarking on a career defined by distinction, pride, compassion, and unwavering service. We are a group of dedicated professionals who thrive in a high-octane, collaborative environment. Our collective brilliance shines as we come together to make a difference in the communities we serve. Here, you'll find the best and the brightest talents, who are second to none in their dedication and expertise. Are you ready to unleash your potential and make a real impact in your community? If you're seeking a rewarding and fulfilling path, then look no further - Life Flight Network is the place where your aspirations will take flight! The Flight Nurse is responsible for working with the Flight Paramedic in the delivery of advanced critical care to patients of the Life Flight Network. The Flight Nurse assumes and is ultimately responsible for all direct patient care in accordance to the guidelines and protocols of Life Flight Network. QUALIFICATIONS & SKILLS Minimum of five (5) years of ICU/ED/Trauma experience within the last ten (10) years. Previous flight experience preferred. Flight experience can be substituted year for year for the ICU/ED/Trauma requirement. Current licensure and/or certification as listed below: RN license as appropriate to assigned location Basic Life Support (BLS) certification Advanced Cardiac Life Support (ACLS) Pre-hospital Trauma Life Support (PHTLS) or Basic Trauma Life Support (BTLS) certification Pediatric Advanced Life Support (PALS Neonatal Resuscitation Program (NRP) certification Transport Professional Advanced Trauma Course (TPATC) certification. Must have successfully completed the TPATC course prior to assuming independent duties. CFRN exam must be taken within one year of hire, certification must be obtained within 2 years of hire Certified Emergency Nurse (CEN) or Critical Care Nurse (CCRN) strongly preferred until certified as a Flight Registered Nurse (CFRN) Drivers must have a current, valid state issued driver's license and at least three years of driving experience. Maintenance of Airport Badge (where applicable) Passport and/or Entry into Canada may be required based on location assignment Complies with weight restrictions (maximum 250 pounds fully outfitted to perform the job) Strong leadership skills and ability to communicate and work with a variety of people one-on-one and in large groups, often in highly stressful situations Ability to work varied shifts and cover fixed wing and/or ambulance call shifts GENERAL ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS CLINICAL QUALITY: The Flight Nurse will perform to the highest standards of nursing. In addition to basic critical care requirements, the Flight Nurse is trained and maintains competency in the following skills: Chest tube insertion, surgical airways, endotracheal intubation, intraosseous insertion, and central line placement. The Flight Nurse, as the senior member of the flight team, is ultimately responsible for all care rendered to the patient. Works with the Flight Paramedic in the delivery of age-appropriate (Pediatric, Adult, Geriatric) patient care Works with the Flight Paramedic as needed in providing accurate and complete patient care documentation per the standards established by LFN Provides written and/or verbal patient follow-up to referring hospitals or agencies Assists with equipment retrieval and return to appropriate agencies Works with the Flight Paramedic in cleaning and restocking equipment in a timely manner to place an aircraft back in service as soon as possible Works with the Flight Paramedic in completing inventories and monthly checks, ordering supplies, and maintaining equipment in working order Works with the Flight Paramedic in the day-to-day operations of LFN May compile statistical data or work on related projects as assigned by the LFN Director of Clinical Operations SAFETY: The expectations of all customers are understood and exceeded through the provision of quality services. Helps to ensure the safe operation of the aircraft for the protection of the patient, crewmembers, and personnel on the scene Enforces LFN safety policies and assists the pilot in navigation, take off, landing, and in-flight procedures BUSINESS DEVELOPMENT: Participates in the development of LFN business and operations plans to meet medical transport service and financial performance goals. Encourages a favorable public opinion of LFN through personal contact with patients, community agencies, and hospitals Provides flight education to the public as requested The above accountabilities represent work performed by this position and are not all-inclusive. The omission of a specific accountability will not preclude it from the position if the work is similar, related, or a logical extension of the position. 🌟 Benefits That Go Above and Beyond At Life Flight Network , we believe our team members deserve more than just a job - they deserve a rewarding, supported, and balanced life. That's why we offer a thoughtful benefits package that truly sets us apart: Compensation & Retirement Competitive pay 401(k) with a 100% vested employer contribution - your future grows from day one Tenure bonuses to reward your loyalty and long-term commitment Health & Wellness Comprehensive Medical, Dental, and Vision coverage Company-paid Life and AD&D Insurance Company-paid Short & Long-Term Disability Insurance for peace of mind Wellness Reimbursement Program to support your health goals Complimentary Life Flight Network Membership for you and your household Family & Lifestyle Paid Parental Leave to support growing families Adoption Assistance for those building families in new ways Bereavement Leave (including for pets) - because every family member matters Paid Volunteer Time - make a difference in the community, on us Generous Paid Time Off, starting at nearly 4 weeks annually for full-time employees Growth & Recognition Tuition and Training Reimbursement to invest in your professional development Employee Recognition Awards celebrating your impact and achievements Multilingual Stipend to honor the value of diverse communication skills Join Life Flight Network and be part of a team that takes care of those who care for others - both in and out of the workplace. All candidates are subject to drug screening and background investigation. Life Flight Network is an equal opportunity employer.
    $64k-79k yearly est. Auto-Apply 30d ago
  • Medical Support Nurse (LPN/RN) [North Seattle]

    We Care Daily Clinics 4.1company rating

    Utilization review nurse job in Seattle, WA

    Medical Support Nurse (LPN/RN) Reports To: Medical Support Team Manager Starting Salary Rate: LPN: $39/hr & RN: $45hr Join Our Mission! We Care Daily Clinics (WCDC), North Seattle, located at 13555 Aurora Ave N. Seattle, WA 98133, is a new clinic that is modelled on our Auburn location. Working at We Care Daily Clinics is rewarding, yet challenging work as you help support our members during some of their most challenging and vulnerable times. WCDC seeks to renew hope and purpose for those battling opioid use by removing barriers, providing a holistic approach to recovery, and utilizing evidence-based treatment to restore healthy living. Our top priority is to provide the highest levels of patient-centered care to those we serve. WCDC is an Opioid Treatment Program (OTP) facility using FDA approved medication paired with behavioral health counseling. Our individual service plans are built around patients in a supportive, safe environment to create a personalized pathway to recovery. In addition to recovery, we also offer planned patient transportation and family and social support. Position Summary The Medical Support LPN plays a vital role in ensuring the safe and efficient delivery of healthcare services, with a strong focus on supporting providers and delivering direct member care. This role involves managing medication administration, supporting clinical operations, and ensuring compliance with regulatory standards. As part of the collaborative Medical Support Team, which includes Medical Assistants and Dispensary Nurses, the LPN contributes to creating a compassionate and efficient care environment. Team members are expected to support one another across duties within their training and licensure. Responsibilities Clinical Support * Assist providers with member care, including exams, treatments, and procedures, ensuring seamless delivery of care. * Administer appropriate medication doses and account for all medication inventory used during a shift. * Perform and document nursing tasks such as tuberculosis tests and referrals for chest x-rays. * Accurately record all nursing documentation in the electronic medical records system, following professional standards. Member Engagement & Education * Provide compassionate care, ensuring members feel supported and informed throughout their treatment. * Educate members about their care plans, medication usage, and follow-up requirements. * Address member questions and concerns with professionalism and empathy. Operational Support * Perform daily clinical activities, ensuring smooth workflows and operational compliance. * Collaborate with colleagues to maintain adequate supplies and medication inventory. * Participate in maintaining the security of medications, member records, and regulatory documentation. Regulatory Compliance * Ensure compliance with all federal, state, and local regulations, including DEA and DOH standards. * Assist with audits and regulatory reviews to uphold WeCare's operational standards. Team Collaboration & Development * Work collaboratively within the Medical Support Team, supporting colleagues across roles when licensure and training allows. * Attend required meetings and training sessions, contributing to the team's overall success and adherence to treatment plans. * Assist in onboarding and training new team members as needed. Education & Licensure * Graduate of an accredited school of nursing with a current Washington state nurse license (LPN or higher). * BLS certification (or the ability to complete within the first 3 months of hire). Preferred Experience & Knowledge * Preferred but Not Required: Experience in behavioral or mental health fields. * Strong understanding of medication administration, dosing, and inventory management. * Experience with electronic medical records systems and Microsoft Office Suite. Physical Requirements * Ability to sit, stand, and walk for extended periods during shifts. * Capability to lift and carry up to 25 lbs., including supplies and files. Additional Requirements * Minimum of 1 year of member care experience in a clinical setting. * Excellent interpersonal, organizational, and communication skills. * Ability to maintain effective working relationships with diverse groups and handle conflicts diplomatically. * Must pass required background checks and drug tests. Work Environment This role operates within the N. Seattle WeCare Clinic, providing care and services in a collaborative and supportive clinical environment. It requires flexibility, adaptability, and a commitment to delivering high-quality, member-centered care. Tribal Preference Statement: We Care Daily Clinic is committed to supporting Indigenous communities. Preference in hiring is given to qualified Native American and Alaska Native applicants in accordance with applicable laws. We celebrate diversity and welcome all applicants who are passionate about our mission! The above statements are intended to describe the general nature and level of work being performed by people assigned to this position. The requirements listed above are representative of the minimum knowledge, skill, and/or ability required. To perform this job successfully, an individual must be able to satisfactorily perform the essential functions of the job according to specific company requirements. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions. Qualified applicants will be afforded equal employment opportunities without discrimination because of race, creed, color, national origin, sex, disability, or marital status. Equal Employment Opportunity (EEO) Statement We Care Daily Clinics is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All employment decisions are based on qualifications, merit, and business need-without regard to race, color, religion, creed, national origin, ancestry, gender, gender identity or expression, sexual orientation, age, marital status, disability, veteran status, genetic information, or any other protected status under applicable laws. We Care Daily Clinics is an equal opportunity employer committed to fostering an inclusive, supportive environment for both members and staff.
    $39 hourly Auto-Apply 29d ago
  • Nursing - Outpatient Clinic

    Virginia Mason Medical Center 4.4company 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. •\tHealth, dental, vision, life, disability benefits and 401k •\tTax free stipends when applicable •\tGym discounts •\tWeekly pay •\t$750. 00 referral bonus Please apply or contract us at: www. venturamedstaff. com or ************
    $68k-87k yearly est. 60d+ ago
  • Nurse Auditor

    Direct Staffing

    Utilization review nurse job in Seattle, WA

    Portland, OR Exp 5-7 years This position can be located in Tacoma, WA; Seattle, WA; Burlington, WA; Salt Lake City UT; Medford, OR; Portland, OR; Lewiston, ID Candidates must work at least 6 months in the office before telecommute work will be considered Job Purpose •Plan, coordinate, conduct and report on post payment claims audits and performs related special projects as assigned. Key Qualifications and Experience: •Proven knowledge of medical and surgical procedures and other healthcare practices and trends. •General computer skills (including use of Microsoft Office, specifically Excel and Outlook, internet search). •Familiarity with health care documentation systems. •Strong verbal, written and interpersonal communication and customer service skills. •Ability to communicate audit outcomes and testing results with other staff within the company who are both medically and non-medically oriented. •Ability to interpret policies and procedures and communicate complex topics to others. •Strong organizational and time management skills with the ability to manage workload independently. •Ability to think critically and make decisions within individual role and responsibility. •Proven ability in developing and following an audit program. •Demonstrated competency in claim review and experience in using billing and claims forms (UB, CMS, and HCFA). Normally to be proficient in the competencies listed above: •Nurse Auditor would have a/an Associate or Bachelor's Degree in Nursing or related field and 5 years of hospital quality management, coding or medical auditing experience or equivalent combination of education and experience. Required Licenses, Certifications, Registration, Etc. •Registered nurse (RN) license (must have a current unrestricted RN license for medical care management). •Certified Coder certified with the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) preferred. General Functions and Outcomes: •Applies clinical expertise and judgment to ensure payments comply with medical policy, medical necessity guidelines, and accepted standards of care. •Utilizes evidence-based criteria that incorporates current and validated clinical research findings. Practices within the scope of their license. •Understands and analyzes complex provider and hospital contracts in order to ensure payments are for covered services. •Conducts coding audits, quality assurance assessments of claims, reviews statistical samples and analyzes for risk. •Conducts surveys of complex audit areas to define the scope and objectives of audits. Assists in the development of overall audit plans, including comprehensive audit programs that identify specific procedures and tests designed to achieve the audit objectives. •Identifies problems or needed changes, recommends resolution, and participates in quality improvement efforts. •Responds in writing or by phone to members, providers and regulatory organizations in a professional manner while protecting confidentiality of sensitive documents and issues. • Provides consistent and accurate documentation. •Plans, organizes and prioritizes assignments to comply with performance standards, corporate goals Skills and Certifications RN license in either WA, OR, ID, UT Certified Professional Coder preferred Ideal Candidate We have several positions open, with one being specific for working with Skilled Nursing Facilities. We would prefer candidates with specific experience in Skilled Nursing Facilities or a varied skill set in a clinical setting, with chart auditing experience strongly preferred. Ideal Candidate should have worked for the following company(ies): Any other health insurance plan Additional Information All your information will be kept confidential according to EEO guidelines. Direct Staffing Inc
    $59k-84k yearly est. 1d ago
  • NIGHT NURSES NEEDED!!!

    Maxim Staffing Solution

    Utilization review nurse job in Shoreline, WA

    Maxim Healthcare Services is a leading provider of home healthcare, medical-related staffing, travel nursing, and population health and wellness services across the United States. Physicians, Case Managers, and other referral sources rely on Maxim for our dedication to providing quality skilled and unskilled homecare services to adult and pediatric patients. Our commitment to customer service, improving patient care, and staffing experienced healthcare professionals has paved the way for many rewarding career opportunities in the healthcare industry. Maxim Healthcare Services, Inc. is an Affirmative Action/Equal Opportunity Employer . Job Description Are you an amazing nurse looking for flexible hours, one on one patient care and an amazing supportive staff? Well look no further! Maxim Healthcare Services can fulfill all these needs and much more. We are seeking a skilled RN or LPN who wants to work in the home of one of our patients in Shoreline, WA . Being apart of a home health environment is extremely beneficial because you alone help sustain and create a healthy patient. Not only that, but you will be able to enhance your skills with gtube, trach and vents! Benefits of working with Maxim: Flexible schedule Supportive office staff Educational opportunities and clinical training Competitive pay and weekly paychecks Health, dental, vision, and life insurance Please contact me to learn more: 425-245-9940 Job Type: Part-time Salary: $27.00 /hour Qualifications Required experience: Nursing: 1 year Pediatric Nursing: 1 year Required licenses or certifications: Registered Nurse Licensed Practical Nurse Additional Information WE ARE OFFERING A $250 LONG TERM COMMITMENT BONUS FOR ANY NIGHT NURSE THAT WILL DEDICATE AT LEAST 6 MONTHS TO A PATIENT. Please contact Anna Fitzpatrick at 425-245-9940 if you are interested in this position or you know someone who would be a great fit!
    $27 hourly 1d ago
  • Nursing - CVOR

    University of Washington Medical Center 4.4company rating

    Utilization review nurse job in Seattle, WA

    Beautiful facility in the great northwest is in need of experienced CVOR RN travelers to fulfill 13 week assignments. Must possess strong and recent CV skills, and also neuro background. 3 years minimum experience, and must be certified ACLS, BLS and have previous travel experience. Call Ventura Medstaff today for more information at ************.
    $70k-84k yearly est. 14d ago
  • Newly Qualified Nurse

    HC-One 4.5company rating

    Utilization review nurse job in Fife, WA

    As a newly qualified nurse at HC-One, you will be supported to grow in your career with our Gold Standard Nursing Preceptorship Programme, helping you to build on your existing skillset while practicing in a nurse-led environment. You will make a difference to our residents at a time of their life when they may feel the most vulnerable, and they will look to you to guide and support them in life-changing decisions, which is a humbling and unbelievably rewarding part of the role. About you You will be a Registered Nurse with a valid Pin number and will understand your commitment to your profession through the standards of practice set by the NMC. You will have a passion to mentor and share your knowledge with your colleagues, along with providing support as a practice supervisor and assessor to students. You will understand the importance of effective communication, both verbally and written, and role model professional behaviours. You will advocate and deliver a person-centred approach to care for the people living in our care home and their families. Safeguarding is everyone's responsibility and therefore it is important that you are able to recognise the signs which may indicate possible abuse, harm or neglect in its different forms and know what to do if there are any concerns. All colleagues are required to attend safeguarding training appropriate to their role and to undertake additional training in associated areas. You also have the ability to seek appropriate advice and report concerns, including escalation if action is not taken. About HC-One At HC-One, kindness is more than a word-it's a way of life. We believe that caring for people means caring about what matters most to them, so we can support them to live their best possible lives. To provide the kindest possible care, everyone at HC-One brings and nurtures five key qualities-what we call Kindness the HC-One Way: * We are curious-asking questions, seeking to understand. * We are compassionate-walking in the shoes of others. * We are creative-finding practical ways to make things happen. * We are courageous-supporting residents to live the life they choose. * And we are dependable-people can always count on us. We champion inclusivity, fostering a workplace where everyone feels valued, respected, and empowered to be themselves. Our diverse workforce helps us learn from one another and better reflect the communities we serve. We welcome applicants from all backgrounds into our HC-One family and prioritise inclusive working practices across everything we do. We are also enhancing the way we support residents through digital care planning. This technology is helping us streamline care, improve outcomes, and make daily tasks more efficient. As we continue to grow our digital capabilities, we're looking for team members who are comfortable with technology-or open to learning. You'll be supported every step of the way. We care about our colleagues and are committed to supporting your personal and professional development. From the moment you receive a job offer, we aim for the quickest possible turnaround to get you started, with full support every step of the way. With clear career pathways, continuous professional development, and postgraduate programmes, HC-One will invest in your growth-opening up opportunities at regional and national levels. To support newly qualified nurses at the start of their career, HC-One is pleased to be the only care home provider in the UK to offer a Gold Standard Nursing Preceptorship Programme. Designed in line with the NHS Gold Standard Framework, our programme follows a structured pattern of learning with an experienced HC-One Nurse who will support you to gain the confidence and competence needed to help our residents lead their best lives. Please note: We are only accepting candidates who are newly qualified and we're only able to consider applications from individuals who already have the full right to work in the UK. Unfortunately, we cannot offer sponsorship or accept applications from those on a time-limited visa. Applications that do not meet this criteria will not be progressed. Rewards & Benefits Are you ready to start your rewarding journey as a newly qualified nurse at one of our HC-One care homes? We are here to support you through every step of your career and are committed to providing you with a quick and clear process from offering you a position to your very first working day. To compliment your salary, we offer paid NMC PIN renewal and access to a huge variety of benefits and services to support your physical and psychological wellbeing. Benefits include: * Paid Enhanced DBS/PVG * Free uniform * Homemade meals whilst on shift * Company pension scheme * 28 days annual leave inclusive of bank holidays (contract dependent) * Group life Assurance cover * Wagestream - financial wellbeing and flexible access to pay as you need it * Award-winning learning and development opportunities, including our Gold Standard Nursing Preceptorship Programme, Aspiring Home Managers Programme and a range of recognised courses and qualifications. * GP online - a service providing around the clock GP consultation via an interactive app - available to you and your children under 16. * An opportunity to learn from experienced colleagues as part of an outstanding and committed team. * Colleague discounts - access to over 1600 high street discounts including carefully selected discount partners. * Wellbeing - free of charge access to an independent and confidential Employee Assistance Programme. This gives Colleagues and their families access to 24/7 365 support for a whole range of issues including physical, mental, and financial issues * Excellent Colleague recognition schemes such as Kindness in Care and Long Service Awards * An attractive refer a friend scheme of up to £1000 per referral, depending on the role Keyboard Shortcuts * F9 - Move focus from the edit area to the Footer Toolbar * F10 - Move focus from the edit area to the first toolbar button * Shift + TAB - Move focus from the edit area to the last toolbar button About You Not Specified Keyboard Shortcuts * F9 - Move focus from the edit area to the Footer Toolbar * F10 - Move focus from the edit area to the first toolbar button * Shift + TAB - Move focus from the edit area to the last toolbar button About The Company Not Specified Keyboard Shortcuts * F9 - Move focus from the edit area to the Footer Toolbar * F10 - Move focus from the edit area to the first toolbar button * Shift + TAB - Move focus from the edit area to the last toolbar button
    $65k-81k yearly est. 13d ago
  • NURSE (CLINICAL/CRITICAL CARE EF)

    DHA 3.8company rating

    Utilization review nurse job in Tacoma, WA

    Madigan Army Medical Center is seeking Critical Care RNs to join our growing team! The facility is one of four Level II Trauma Centers in Washington State and participates in unique partnerships with civilian facilities to provide care to non-beneficiary trauma victims beyond the gates of Joint Base Lewis-McChord. At Madigan you will practice alongside civilian and military health care experts and experience unique professional opportunities. Our staff serves by caring for our military but are not subject to military requirements. We operate within safe staffing standards - giving you time to provide exceptional care. About the Position: These positions are located at Madigan Army Medical Center in Tacoma, Washington. Recruitment or Relocation incentives MAY be authorized. Advance-in Hire/Salary negotiation may be available to candidates who are new to Federal service. This is a Direct Hire SolicitationThis job is open to The publicU.S. Citizens, Nationals or those who owe allegiance to the U.S. Located in the beautiful Pacific Northwest on the Puget Sound, in Washington State, Joint Base Lewis-McChord is near the city of Lakewood, 10 minutes from Tacoma and 20 minutes from Olympia, the state capitol. JBLM is situated in a key location along Interstate 5, allowing easy access to Sea-Tac Airport and to the deep water ports of Tacoma and Seattle. Although the Army and Air Force missions have changed over the years, one thing has not changed-the natural setting of the base. On a clear day, majestic Mount Rainier looms on the horizon, towering over the other peaks of the Cascade Range. From the mountains to the deep waters of Puget Sound and the Pacific Ocean, the local areas abound in natural beauty and outdoor recreation opportunities. Camping, hunting, fishing, hiking, boating and now sports are a way of life in Washington State. Working for the Department of Defense comes with an abundance of benefits and perks to include competitive compensation packages, paid-time off, medical benefits, student loan repayments, and retirement package with Thrift Savings Plan to include matching employer contributions. For more information, please visit the following link: ************************************************************* Responsibilities Duties: Deliver advanced, specialized nursing care to critically ill pediatric patients ranging in age from neonate to 18 years. Provide support to physicians during complex and potentially life-threatening procedures, including cardioversion and the insertion of invasive lines such as arterial, venous, and pulmonary artery catheters. Prepare and administer high-risk medications as well as intravenous fluids, in support of initiating advanced cardiovascular life support interventions. Assess patients cardiac output, vital signs, peripheral perfusion, and level of consciousness, and evaluate blood gas results, including arterial and mixed venous oxygen saturation. Assess the effectiveness of nursing interventions based on patient responses and modify the care plan as needed to ensure optimal outcomes. Design Family Nursing Care Plans to support critically ill patients and their families in achieving the highest possible level of physiological, sociological, and psychological. Performs other duties as assigned. Qualifications Who May Apply: US Citizens In order to qualify, you must meet the education and experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. Basic Requirement for Nurse (Clinical/Critical Care Expanded Functions): Degree: A graduate or higher level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. (Note: You must attach a copy of your transcripts.) Licensure: A current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States; and you must have passed the National Council Licensure Examination. Foreign Degree: A degree from a Foreign Nursing School. Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools. Exemption: You are exempt from the basic requirements above if you are a current federal employee occupying a position in the 0610 occupational series and have been continuously employed in this occupational series since September 27, 2017 or before. Applicants claiming this exemption must meet the requirement below. Note: You will be required to provide appropriate documentation to the respective Human Resources Office to validate your status. Degree or diploma from a professional nursing program approved by the legally designated State accrediting agency at the time the program was completed by the applicant. Active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. In addition to meeting the basic requirement above, to qualify for this position you must also meet the qualification requirements listed below: Education/Experience: A diploma, associate degree, or bachelor's degree in Nursing from a professional nursing program and possession of at least one full year of professional nursing experience (equivalent to the GS-9 grade level or above) delivering comprehensive care to critically ill pediatric patients in an intensive care setting which included managing patients with complex and life-threatening conditions such as congenital heart disease, kidney failure, and respiratory failure; administering medications through various routes; operating medical equipment including hemodynamic monitoring devices and invasive Thermodilution catheters, and providing continuous support to patients and their families on disease processes, as well as guidance on pre-operative and post-operative care to promote understanding and recovery. (Note: You must attach a copy of your transcripts.) OR Education: A PhD or equivalent doctoral degree from a professional nursing educational program or related medical science field. Exemption: You are exempt from the qualification requirements above if you are a current federal employee occupying a position in the 0610 occupational series and have been continuously employed in this occupational series since September 27, 2017 or before. Applicants claiming this exemption must meet one of the requirement below. Completion of all requirements for a doctoral degree (Ph.D. or equivalent) from a professional nursing program OR 3 full years of progressively higher level graduate education from a professional nursing program Education FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: ************************************************************************** Foreign Degree: A degree from a Foreign Nursing School. Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools. Additional information Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration. You will be required to provide proof of U.S. Citizenship. One year trial/probationary period may be required. Direct Deposit of Pay is required. Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees. Recruitment or relocation incentives MAY be authorized for highly qualified candidates. Advance-in Hire/Salary negotiation may be available to candidates who are new to Federal service. Multiple positions may be filled from this announcement. Salary includes applicable locality pay or Local Market Supplement. If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the Reemployed Annuitant information sheet. Payment of Permanent Change of Station (PCS) costs is not authorized, based on a determination that a PCS move is not in the Government interest. Multiple positions will be filled from this announcement. Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
    $64k-79k yearly est. Auto-Apply 6d ago
  • Nurse (LVN/LPN)

    Epiphany Business Services, LLC 4.5company rating

    Utilization review nurse job in Bellevue, WA

    Are you looking for an incredible opportunity to join a dynamic, fast-growing dermatology services company? Epiphany Dermatology, headquartered in Austin, TX, is on a mission to improve access to dermatology services and provide exceptional patient care in underserved markets across the U.S. We are looking for a service-oriented, motivated individual to join us as a Nurse (LPN/LVN) to accomplish this mission. With ambitions to increase our reach over the next four to five years, our quickly expanding company has gone from a single site in 2015 to nearly 100 dermatological clinics nationwide. Our employees are the key to our success and we're proud to offer eligible employees great benefits (many at no cost!), perks like free skin care, generous time off plans, the opportunity for growth, and the chance to be part of a purpose-driven organization taking patient care to the next level. We are excited to grow our team with individuals who are as passionate about our patients as we are and invest a lot of time and energy in our employees' development because we believe being a part of the Epiphany team is a career opportunity-not just another job. If you are interested in joining this mission-driven team, please consider applying today! What we are looking for: LPN/LVNs are the backbone of our clinics and instrumental to our success so, we're looking for someone dedicated to providing the best care possible with a big emphasis on empathy. Our LPN/LPNs are expected to execute a variety of daily support functions that are critical to providing quality care and ensuring our clinic runs smoothly. The ideal candidate should be totally comfortable demonstrating competency in all skills related to patient care … Bonus points if you are also great at making others smile! What you'll do: Maintain efficient patient flow, while supporting patient safety and satisfaction. Collect and document patient information, clinical data, and other relevant details accurately and timely while ensuring patient confidentiality. Respond to care questions or complaints to immediately resolve. Deliver patient care per provider orders, based on practice guidelines and applicable regulations. Maintain and use principles of aseptic techniques and infection control standards. Practice strict adherence to all OSHA standards. Operate clinical equipment according to equipment guidelines. Perform time-sensitive delegated tasks. Not limited to requests for prescription refills, EHR alerts, and messages. Order, stock, and maintain exam rooms and supply storage areas using par levels of supplies, medications, linens, forms, and equipment. Monitor expiration dates and act accordingly. Participate in staff meetings and provide constructive input for improvements and solutions. Other duties as assigned. If you're a hard worker with excellent customer service skills who understands the importance of doing your best to take care of every patient … we want to talk to you! It'll help to have/be: Able to adjust personal availability according to volume changes and activity surges. The ability to adhere to a compliance program and HIPAA standards and policies. Maintains LVN/LPN certification in accordance with national recertification requirements (as required by state). Able to receive and apply constructive input for performance improvement and growth. Experience with EHR systems - not required but highly desired. Qualifications/Experience: High school diploma or general education degree (GED). Graduate of an accredited Nursing program. Current active and unrestricted RN state license. Work environment and physical requirements: Medical office, procedure/exam room and laboratory environment may include exposure to communicable diseases, bloodborne pathogens, biohazards or toxic substances. Daily activities may include standing, walking, sitting, bending and lifting items up to 30 lbs. Benefits: We offer generous benefits including medical, life insurance, short-term disability coverage, mental health services, and more at no cost for eligible employees. In addition, we have great vision, dental, and supplemental insurance options. We also offer 401k with company matching, employee discounts, HSA and FSA/dependent care, tuition assistance, certification reimbursement, and more!
    $52k-64k yearly est. Auto-Apply 44d ago
  • Field Nurse (LPN)

    Concertocare

    Utilization review nurse job in Lakewood, WA

    Apply Description 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. 7d ago
  • Medical Support Nurse (LPN/RN) [North Seattle]

    We Care Daily Clinics 4.1company rating

    Utilization review nurse job in Seattle, WA

    Job Description Medical Support Nurse (LPN/RN) Reports To: Medical Support Team Manager Starting Salary Rate: LPN: $39/hr & RN: $45hr Join Our Mission! We Care Daily Clinics (WCDC), North Seattle, located at 13555 Aurora Ave N. Seattle, WA 98133, is a new clinic that is modelled on our Auburn location. Working at We Care Daily Clinics is rewarding, yet challenging work as you help support our members during some of their most challenging and vulnerable times. WCDC seeks to renew hope and purpose for those battling opioid use by removing barriers, providing a holistic approach to recovery, and utilizing evidence-based treatment to restore healthy living. Our top priority is to provide the highest levels of patient-centered care to those we serve. WCDC is an Opioid Treatment Program (OTP) facility using FDA approved medication paired with behavioral health counseling. Our individual service plans are built around patients in a supportive, safe environment to create a personalized pathway to recovery. In addition to recovery, we also offer planned patient transportation and family and social support. Position Summary The Medical Support LPN plays a vital role in ensuring the safe and efficient delivery of healthcare services, with a strong focus on supporting providers and delivering direct member care. This role involves managing medication administration, supporting clinical operations, and ensuring compliance with regulatory standards. As part of the collaborative Medical Support Team, which includes Medical Assistants and Dispensary Nurses, the LPN contributes to creating a compassionate and efficient care environment. Team members are expected to support one another across duties within their training and licensure. Responsibilities Clinical Support Assist providers with member care, including exams, treatments, and procedures, ensuring seamless delivery of care. Administer appropriate medication doses and account for all medication inventory used during a shift. Perform and document nursing tasks such as tuberculosis tests and referrals for chest x-rays. Accurately record all nursing documentation in the electronic medical records system, following professional standards. Member Engagement & Education Provide compassionate care, ensuring members feel supported and informed throughout their treatment. Educate members about their care plans, medication usage, and follow-up requirements. Address member questions and concerns with professionalism and empathy. Operational Support Perform daily clinical activities, ensuring smooth workflows and operational compliance. Collaborate with colleagues to maintain adequate supplies and medication inventory. Participate in maintaining the security of medications, member records, and regulatory documentation. Regulatory Compliance Ensure compliance with all federal, state, and local regulations, including DEA and DOH standards. Assist with audits and regulatory reviews to uphold WeCare's operational standards. Team Collaboration & Development Work collaboratively within the Medical Support Team, supporting colleagues across roles when licensure and training allows. Attend required meetings and training sessions, contributing to the team's overall success and adherence to treatment plans. Assist in onboarding and training new team members as needed. Education & Licensure Graduate of an accredited school of nursing with a current Washington state nurse license (LPN or higher). BLS certification (or the ability to complete within the first 3 months of hire). Preferred Experience & Knowledge Preferred but Not Required: Experience in behavioral or mental health fields. Strong understanding of medication administration, dosing, and inventory management. Experience with electronic medical records systems and Microsoft Office Suite. Physical Requirements Ability to sit, stand, and walk for extended periods during shifts. Capability to lift and carry up to 25 lbs., including supplies and files. Additional Requirements Minimum of 1 year of member care experience in a clinical setting. Excellent interpersonal, organizational, and communication skills. Ability to maintain effective working relationships with diverse groups and handle conflicts diplomatically. Must pass required background checks and drug tests. Work Environment This role operates within the N. Seattle WeCare Clinic, providing care and services in a collaborative and supportive clinical environment. It requires flexibility, adaptability, and a commitment to delivering high-quality, member-centered care. Tribal Preference Statement: We Care Daily Clinic is committed to supporting Indigenous communities. Preference in hiring is given to qualified Native American and Alaska Native applicants in accordance with applicable laws. We celebrate diversity and welcome all applicants who are passionate about our mission! The above statements are intended to describe the general nature and level of work being performed by people assigned to this position. The requirements listed above are representative of the minimum knowledge, skill, and/or ability required. To perform this job successfully, an individual must be able to satisfactorily perform the essential functions of the job according to specific company requirements. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions. Qualified applicants will be afforded equal employment opportunities without discrimination because of race, creed, color, national origin, sex, disability, or marital status. Equal Employment Opportunity (EEO) Statement We Care Daily Clinics is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All employment decisions are based on qualifications, merit, and business need-without regard to race, color, religion, creed, national origin, ancestry, gender, gender identity or expression, sexual orientation, age, marital status, disability, veteran status, genetic information, or any other protected status under applicable laws. We Care Daily Clinics is an equal opportunity employer committed to fostering an inclusive, supportive environment for both members and staff.
    $39 hourly 29d ago
  • Nursing - L&D

    University of Washington Medical Center 4.4company 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. •\tHealth, dental, vision, life, disability benefits and 401k •\tTax free stipends when applicable •\tGym discounts •\tWeekly pay •\t$750. 00 referral bonus Please apply or contract us at: www. venturamedstaff. com or ************
    $70k-84k yearly est. 1d ago
  • Calling All Nurses For A Psych Facility!

    Maxim Staffing Solution

    Utilization review nurse job in Bellevue, WA

    Maxim Healthcare is an industry leader, providing compassionate home healthcare since 1988. As a full-service healthcare company, we have earned a reputation for providing innovative solutions that improve health and enhance the quality of life for our patients. Maxim specializes in contractual and direct placement positions. Job Description Hey There! Maxim Staffing Solutions is looking to hire multiple RNs & LPNs for a Psychiatric Client who operates a Clinic that focuses on Eating Disorders. These are Contract and/or Direct Placement opportunities. They have openings for all shifts; weekdays, weekends, days, and nights! This is a great opportunity for somebody who enjoys being in the Psych field or would like to get their foot in the door. This is a great looking, modern facility that you will love to work in. Most patients will have some sort of eating disorder and/or a low acuity psychological issue. Are client is looking for nurses to start ASAP, but are willing to be flexible if you are currently working at another opportunity. We offer above average psychiatric pay! If you or anyone you know might be a great fit I would love to chat! We offer big $$$ referral bonuses for quality candidates! Thank you! Best Regards, Riley Brindle Recruiting Specialist - Maxim Staffing Solutions 9703 3rd Ave NE Suite 309 Seattle, WA 98115 Ph: (206) 527-1911 Fax: (206) 729 7319 Qualifications Requirements: • Current WA State License • At Least 3 Months of Clinical Experience o Preferably in Some Type of Psych Setting Additional Information If you are interested or know someone that will benefit in this opportunity, please let us know. You can call 866-21116190 or send us your most updated resume and we;ll get in touch ASAP!
    $59k-84k yearly est. 1d ago
  • Nurse (Progressive Care Unit Nurse)

    DHA 3.8company rating

    Utilization review nurse job in Tacoma, WA

    Madigan Army Medical Center is seeking Progressive Care/Step Down RNs to join our growing team! About the Position: This position is located within the Department of Nursing, management of critical care patients. Tacoma, Washington. Relocation or Recruitment incentives May be authorized to highly qualify candidates. Salary negotiation may be available for those candidates who are new to Federal service. This is a Direct Hire Solicitation The facility is one of four Level II Trauma Centers in Washington State and participates in unique partnerships with civilian facilities to provide care to non-beneficiary trauma victims beyond the gates of Joint Base Lewis-McChord. At Madigan you will practice alongside civilian and military health care experts and experience unique professional opportunities. Our staff serves by caring for our military but are not subject to military requirements. We operate within safe staffing standards - giving you time to provide exceptional care. Located in the beautiful Pacific Northwest on the Puget Sound, in Washington State, Joint Base Lewis-McChord is near the city of Lakewood, 10 minutes from Tacoma and 20 minutes from Olympia, the state capitol. JBLM is situated in a key location along Interstate 5, allowing easy access to Sea-Tac Airport and to the deep water ports of Tacoma and Seattle. Although the Army and Air Force missions have changed over the years, one thing has not changed-the natural setting of the base. On a clear day, majestic Mount Rainier looms on the horizon, towering over the other peaks of the Cascade Range. From the mountains to the deep waters of Puget Sound and the Pacific Ocean, the local areas abound in natural beauty and outdoor recreation opportunities. Camping, hunting, fishing, hiking, boating and now sports are a way of life in Washington State. Working for the Department of Defense comes with an abundance of benefits and perks to include competitive compensation packages, paid-time off, medical benefits, student loan repayments, and retirement package with Thrift Savings Plan to include matching employer contributions. For more information, please visit the following link: ************************************************************* Responsibilities Duties: Provide specialized nursing care to assigned patients. Monitor patient condition and implement timely interventions to prevent complications and promote recovery. Initiate appropriate emergency interventions upon recognizing and assessing life-threatening conditions to deliver timely, life-saving care. Initiate advanced cardiovascular life support (ACLS) protocols by preparing and administering high-potency medications such as Nipride, dopamine, atropine, nitroglycerin, and dobutamine to manage life-threatening cardiac conditions. Support physicians during complex and potentially life-threatening procedures, including cardioversion and the placement of invasive lines such as arterial, central venous, and pulmonary artery catheters. Evaluate patient responses by monitoring cardiac output, vital signs, peripheral perfusion, and level of consciousness. Coordinate referrals to appropriate allied health professionals such as Chaplains, Community Health Nurses, and Social Workers based on patient and family needs Administer a combination of high-potency and potentially life-threatening medications through invasive lines as part of critical care interventions. Performs other duties as assigned. Qualifications Who May Apply: US Citizens In order to qualify, you must meet the education and experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. Basic Requirement for Nurse (Clinical/Critical Care): Degree: A graduate or higher-level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. (Note: You must attach a copy of your transcripts.). Licensure: A current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States; and you must have passed the National Council Licensure Examination. Foreign Degree: Graduates of foreign nursing schools must have completed the Commission on Graduates of Foreign Nursing Schools Certification Program. The certification program consists of a credential's evaluation, the CGFNS Qualifying Exam, and evidence of passing one of the approved English Language Proficiency examinations. A copy of the CGFNS Certificate is required. Exemption: You are exempt from the basic requirements above if you are a current federal employee occupying a position in the 0610 occupational series and have been continuously employed in this occupational series since September 27, 2017 or before. Applicants claiming this exemption must meet the requirement below. Note: You will be required to provide appropriate documentation to the respective Human Resources Office to validate your status. Degree or diploma from a professional nursing program approved by the legally designated State accrediting agency at the time the program was completed by the applicant. Active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. In addition to meeting the basic requirement above, to qualify for this position you must also meet the qualification requirements listed below: Education and Experience: A diploma, associate degree, or bachelor's degree in nursing from a professional nursing program and possession of at least one full year of professional nursing experience (equivalent to the GS-9 grade level or above) which includes providing care to moderately stable, less complex patients requiring moderate resources and intermittent nursing care, as well as stable patients with a high potential for becoming unstable who require increased monitoring and intensity of care and performing detailed assessments specific to acutely ill patients, administer medications via oral, intramuscular, subcutaneous, intradermal, and intravenous routes, and actively engage in patient advocacy to ensure the highest standards of care and ethical practice are upheld. (Note: You must attach a copy of your transcripts.) OR Education: A PhD or equivalent doctoral degree from a professional nursing educational program or related medical science field including but not limited to such as e.g., Doctor of Nursing Practice (DNP), Doctor of Public Health (DrPH), or Doctor of Medical Science (DMSc), or other specialties identified for the position. (Note: You must attach a copy of your transcripts.) EXEMPTION: You are exempt from the qualification requirements above if you are a current federal employee occupying a position in the 0610 occupational series and have been continuously employed in this occupational series since September 27, 2017 or before. Applicants claiming this exemption must meet one of the requirement below. Note: You will be required to provide appropriate documentation to the respective Human Resources Office to validate your status. Completion of all requirements for a doctoral degree (Ph.D. or equivalent) from a professional nursing program OR 3 full years of progressively higher-level graduate education from a professional nursing program Education FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: ************************************************************************** Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools (external link) is required for individuals who graduated from foreign nursing schools.
    $64k-79k yearly est. Auto-Apply 6d ago
  • Nurse Auditor

    Direct Staffing

    Utilization review nurse job in Burlington, WA

    Burlington, WA Exp 5-7 years This position can be located in Tacoma, WA; Seattle, WA; Burlington, WA; Salt Lake City UT; Medford, OR; Portland, OR; Lewiston, ID Candidates must work at least 6 months in the office before telecommute work will be considered Job Purpose •Plan, coordinate, conduct and report on post payment claims audits and performs related special projects as assigned. Key Qualifications and Experience: •Proven knowledge of medical and surgical procedures and other healthcare practices and trends. •General computer skills (including use of Microsoft Office, specifically Excel and Outlook, internet search). •Familiarity with health care documentation systems. •Strong verbal, written and interpersonal communication and customer service skills. •Ability to communicate audit outcomes and testing results with other staff within the company who are both medically and non-medically oriented. •Ability to interpret policies and procedures and communicate complex topics to others. •Strong organizational and time management skills with the ability to manage workload independently. •Ability to think critically and make decisions within individual role and responsibility. •Proven ability in developing and following an audit program. •Demonstrated competency in claim review and experience in using billing and claims forms (UB, CMS, and HCFA). Normally to be proficient in the competencies listed above: •Nurse Auditor would have a/an Associate or Bachelor's Degree in Nursing or related field and 5 years of hospital quality management, coding or medical auditing experience or equivalent combination of education and experience. Required Licenses, Certifications, Registration, Etc. •Registered nurse (RN) license (must have a current unrestricted RN license for medical care management). •Certified Coder certified with the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) preferred. General Functions and Outcomes: •Applies clinical expertise and judgment to ensure payments comply with medical policy, medical necessity guidelines, and accepted standards of care. •Utilizes evidence-based criteria that incorporates current and validated clinical research findings. Practices within the scope of their license. •Understands and analyzes complex provider and hospital contracts in order to ensure payments are for covered services. •Conducts coding audits, quality assurance assessments of claims, reviews statistical samples and analyzes for risk. •Conducts surveys of complex audit areas to define the scope and objectives of audits. Assists in the development of overall audit plans, including comprehensive audit programs that identify specific procedures and tests designed to achieve the audit objectives. •Identifies problems or needed changes, recommends resolution, and participates in quality improvement efforts. •Responds in writing or by phone to members, providers and regulatory organizations in a professional manner while protecting confidentiality of sensitive documents and issues. • Provides consistent and accurate documentation. •Plans, organizes and prioritizes assignments to comply with performance standards, corporate goals Skills and Certifications RN license in either WA, OR, ID, UT Certified Professional Coder preferred Ideal Candidate We have several positions open, with one being specific for working with Skilled Nursing Facilities. We would prefer candidates with specific experience in Skilled Nursing Facilities or a varied skill set in a clinical setting, with chart auditing experience strongly preferred. Ideal Candidate should have worked for the following company(ies): Any other health insurance plan Additional Information All your information will be kept confidential according to EEO guidelines. Direct Staffing Inc
    $60k-83k yearly est. 1d ago
  • Field Nurse (LPN)

    Concertocare

    Utilization review nurse job in Bonney Lake, WA

    Apply Description Licensed Practical Nurse - Bonney Lake or Puyallup 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. Vaccination 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 $35.00 - $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
    $35-42 hourly 7d ago

Learn more about utilization review nurse jobs

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

The average utilization review nurse in Shoreline, 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 Shoreline, WA

$73,000

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

The biggest employers of Utilization Review Nurses in Shoreline, WA are:
  1. EvergreenHealth
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