Top 59 Utilization review Jobs in Seattle, Wa

RN Manager - Case Management
Valley Medical Center —Renton, WA
- From $47.48 an hour
- Full-time
- Acute care
- Background check
- Nursing
- Free parking
- Health insurance
Quick Apply
Utilization Review Nurse
Virginia Mason Medical Center —Seattle, WA
- $52.03 - $101.24 an hour
- Part-time
- Acute care
- Nursing
- RN License
1d
State Hospital Liaison
Community Health Plan of Washington —Seattle, WA
- $85,390 - $134,060 a year
- Full-time
- Nursing
- RN License
- Hospital
- Paid jury duty
- Health savings account
Quick Apply
Manager, Clinical Utilization Management & Transitions of Care
Community Health Plan of Washington —Seattle, WA
- $101,740 - $163,800 a year
- Full-time
- Nursing
- RN License
- Office
- Paid jury duty
- Health savings account
Quick Apply
Clinical Documentation Specialist
Valley Medical Center —Renton, WA
- $94,894 - $142,341 a year
- Full-time
- Nursing
- RN License
- Hospital
Oncology Social Worker
Virginia Mason Medical Center —Seattle, WA
- $43.01 - $70.97 an hour
- Full-time
- Master of Social Work
- Mid-level
- Organizational skills
5d
Admissions Director.
820 NW 95th Street Operations LLC —Seattle, WA
- $72,800 - $82,784 a year
- Skilled nursing facility
- Marketing
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Patient Authorization and Referral Representative - USFHP
Pacific Medical Centers —Seattle, WA
- $22.62 - $35.22 an hour
- Full-time
- Mid-level
- Office
- Fair chance
- Paid parental leave
- Paid holidays
Case Manager
The Emily Program —Seattle, WA
- $25 - $30 an hour
- Full-time
- Mid-level
- Outpatient experience
- Driver's License
- Health savings account
- Paid holidays
Quick Apply
Manager, Transitions of Care
Overlake Medical Center and Clinics —Bellevue, WA
- $111,155 - $177,840 a year
- Day shift
- Nursing
- RN License
- Hospital
- Tuition reimbursement
- Employee assistance program
7d
Family Nurse Practitioner (PRN, Part time)
Thira Health —Bellevue, WA
- $65 - $80 an hour
- Temporary
- Nursing
- Medication administration
- Psychiatry
- Paid parental leave
- AD&D insurance
Quick Apply
Primary Therapist
Thira Health —Bellevue, WA
- $34 - $50 an hour
- Weekends as needed
- LMFT
- Adults
- HIPAA
- Paid parental leave
- Health savings account
Quick Apply
Resident Care Manager/Admissions
Belmont Terrace —Bremerton, WA
- $95,000 - $110,000 a year
- Full-time
- Background check
- Vital signs
- RN License
- Health insurance
- Dental insurance
Quick Apply
PRIMARY THERAPIST
THIRA HEALTH —Bellevue, WA
- $34 - $50 an hour
- Weekends as needed
- LMFT
- HIPAA
- Inpatient
Quick Apply
MDS Coordinator Nurse (RN)
Seattle Medical Post Acute Care —Seattle, WA
- $50 - $54 an hour
- Full-time
- Skilled nursing facility
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Financial Counselor - Outpatient
Fairfax Behavioral Health —Kirkland, WA
- $21.50 - $30.38 an hour
- Full-time
- Mid-level
- High school diploma or GED
- In-person
- Health insurance
- Dental insurance
Quick Apply
Amwins A&H- Claims Manager, Stop Loss
Amwins —Seattle, WA
- $140,000 - $155,000 a year
- Remote
- Bachelor's degree
- Mentoring
- Organizational skills
Quick Apply
Clinical Liaision (Paramedic / Allied Health Professional)
myLaurel —Seattle, WA
- $100,000 - $105,000 a year
- Full-time
- Acute care
- Hospital
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
13d
Senior Provider Network Contract Specialist - USFHP
Pacific Medical Centers —Renton, WA
- $39.45 - $61.24 an hour
- Full-time
- Hybrid work
- 5 years
- Office
- Bachelor's degree
- Paid parental leave
- Paid holidays
Manager, Case Management - RN or MSW
Seattle Children's Hospital —Seattle, WA
- $129,992 - $194,988 a year
- Master of Social Work
- Nursing
- Management
- Relocation assistance
- Health insurance

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utilization review jobs near seattle, wa

RN Manager - Case Management

Valley Medical Center -
Renton, WA

Quick Apply

Job Details

Full-time
From $47.48 an hour

Benefits

Free parking
Health insurance
Dental insurance
Paid time off
Vision insurance
403(b)
Life insurance

Qualifications

Inpatient experience
RN License
Writing skills
English
Acute care facility experience
Typing

Full Job Description

TITLE: Manager, Case Management

AREA OF ASSIGNMENT: Case Management

HOURS OF WORK: Typically, day shift Monday - Friday with weekend and holiday rotation.

The position description is a guide to the critical duties and essential functions of the job, not an all- inclusive list of responsibilities, qualifications, physical demands and work environment conditions.
Position descriptions are reviewed and revised to meet the changing needs of the organization.

JOB DESCRIPTION:

The RN Case Manager facilitates discharge coordination, effective patient throughput in the inpatient setting, and continuity of care for specified populations in the acute care setting.
This includes collaboration with patients, surrogates, families, physicians, nurses, and other members of the health care team to address patient needs through effective coordination of services.
The RN Case Manager evaluates clinical requirements, synthesizing patient goals of care, treatment preferences, and available resources in the development of a discharge plan that accounts for continuum of care needs and is commensurate with the patient's right to self-determination.

PREREQUISITES:

Current license as a registered nurse in the State of Washington.
Minimum five years recent clinical experience as an RN working in an acute care setting required; 3 years of experience as a case manager preferred.
Bachelor's degree preferred.
Certification in Case Management preferred.
Ability to communicate fluently in English, both verbally and in writing.
Ability to type fluently and quickly; write legibly, spell correctly, and use accepted grammar.

QUALIFICATIONS:

Ability to assess the clinical requirements of care in the medical setting; and to create, implement, and evaluate the effectiveness of care plans which address identified needs.
Ability to meet and demonstrate VMC's mission, vision, and values, and abide by the VMC Caregiver Commitment.
Effective communication skills, including group facilitation and conflict management skills.
Ability to work in a collaborative team setting with peers.
Interpersonal skills necessary to interact with the multidisciplinary team of care providers, to coordinate care for patients and families.
Demonstrates sensitivity and compassion in the coordination of care requirements for all patients and families from a variety of ethnic, cultural, social, and economic backgrounds and with varied medical and developmental needs.
Knowledge of community resources and how to access them effectively and efficiently.
Knowledge of the healthcare financial environment, reimbursement methodologies, and length of stay management.
Ability to work independently without close supervision; while managing multiple demands, prioritizing and producing accurate work, while meeting outcome expectations and deadlines.
Ability to function in multiple and varied settings throughout the facility.
Neat and well-groomed appearance consistent with VMC dress code policy.
Experienced navigator of basic electronic applications including Outlook, Office, and calendar management.
Experienced in use of electronic health record (EHR).

UNIQUE PHYSICAL/MENTAL DEMANDS, ENVIRONMENT AND WORKING CONDITIONS:

See Generic Job Description for Clinical Partner.

PERFORMANCE RESPONSIBILITIES:

A. Generic Job Functions:

See Generic Job Description for Clinical Partner.

B. Essential Responsibilities and Competencies

Collaborate with partners on the care team including social work and discharge coordinators by facilitating timely medical case reviews, addressing priority of patient care needs based on case load, and allocating distribution of patient case load based on medical complexity of care.
Assess, plan, and facilitate discharges and transitions of care for the medically complex patient population including the following: review past and present medical records to determine history, admitting diagnosis or procedure, and plan of care compared to previous history and care needs.
Collaborate with the patient or surrogate in the gathering of pertinent information about the patient's psychosocial, functional and financial situation to identify needs or barriers to care.
Communicate with the multidisciplinary team (physicians, nurses, therapists, social workers, chaplain, etc.) as needed to complete assessment.
Establish a discharge plan based upon individual patient needs, patient preferences, and existing or proposed treatment options in order to support and promote desired clinical, outcomes in a timely manner.
Provide relevant education and information regarding resources to patient/surrogate to facilitate informed decision making and active participation in the plan for transfer/discharge.
Identify, address, and implement goals of care and treatment preferences with patient/surrogate regarding available options, empowering the ability to make choices in their best interest.
Identify benefits and coordinate resources based on patient's needs and preferences.
Work with insurance companies and/or public health benefit programs (DSHS, Medicare, Medicaid, County, State) to optimize benefits available to the patient.
Initiate timely family conferences or multidisciplinary case conferences with the treatment team for complex transition discharges.
Respond to nurse, physician, and admission review screens in a timely manner.
Manage readmission reviews including root cause analysis; facilitate patient engagement as an active participant of the treatment team by addressing goals of care, treatment preferences, and strategies for successful transitions to lower levels of care.
Engage in post-discharge follow up to manage successful transitions in care.
Independently complete assessment and plan interventions sensitive to the patient's cultural, social, physical, mental and economic status and developmental state.
Demonstrate sensitivity to the patient's/caregiver's beliefs and values and incorporate that understanding into the discharge plan.
Manage and prioritize work based on clinical needs, length of stay, required complexity of interventions, and acuity of care.
Document all assessments, plans, and interventions in the medical record with clarity and conciseness unique to each specific patient or family interaction and in accordance with professional, legal, regulatory and departmental standards in a timely manner.
Complete and/or review admission review assessments to identify potentially high-risk patients who may have an adverse health consequence without a case management order.
Communicate effectively with other members of the multidisciplinary care team using appropriate interpersonal skills, group facilitation and conflict management skills as appropriate.
Maintain current knowledge of case management, utilization management, and discharge planning resources.
Work collaboratively with the Utilization Management team and Patient Financial Counselors.
Refer quality, infection control, and risk management issues to the appropriate individual or department.
Perform other duties as assigned, including orientation and training of new staff members.
Serve as committee member or liaison to community partners per request of management.

Job Type: Full-time

Pay: From $47.48 per hour

Benefits:

403(b)
Dental insurance
Free parking
Health insurance
Life insurance
Paid time off
Vision insurance

Ability to Commute:

Renton, WA 98058 (Required)

Work Location: In person

Quick Apply

Refine Your Search

utilization review jobs in seattle, wa

RN Manager - Case Management

Utilization Review Nurse

State Hospital Liaison

Manager, Clinical Utilization Management & Transitions of Care

Clinical Documentation Specialist

Oncology Social Worker

Admissions Director.

Patient Authorization and Referral Representative - USFHP

Case Manager

Manager, Transitions of Care

Family Nurse Practitioner (PRN, Part time)

Primary Therapist

Resident Care Manager/Admissions

PRIMARY THERAPIST

MDS Coordinator Nurse (RN)

Financial Counselor - Outpatient

Amwins A&H- Claims Manager, Stop Loss

Clinical Liaision (Paramedic / Allied Health Professional)

Senior Provider Network Contract Specialist - USFHP

Manager, Case Management - RN or MSW

I want to receive the latest job alert for utilization review in seattle, wa

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