RN - Utilization Review
$46.3 - $91.32 per hourProvidence Health and Services
Description
The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient processes for determining the appropriate admission status based on regulatory and reimbursement requirements of commercial and government payers.
Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence St. Peter Hospital and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
- Upon hire: Washington Registered Nurse License
- 3 years of Nursing
Preferred Qualification:
- Bachelor's Degree Or Associate's Degree in Nursing
- 3 years of Utilization Review, Care Management, Quality Management, and/or Discharge planning
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
About the Team
Providence has been serving the Pacific Northwest since 1856 when Mother Joseph and four other Sisters of Providence arrived in Vancouver, Washington Territory. Today, Providence is the largest health care provider in Washington located in communities large and small across the state. In western Washington, Providence provides care throughout the greater Puget Sound from Snohomish County to Lewis County.
Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
For any concerns with this posting relating to the posting requirements in RCW 49.58.110(1), please click here where you can access an email link to submit your concern.
Requsition ID: 397848
Company: Providence Jobs
Job Category: Health Information Management
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Nursing
Department: 3030 UTILIZATION REVIEW WA PSPH OLYMPIA MAIN 2ND FLOOR QUALITY OFFICES
Address: WA Olympia 413 Lilly Rd NE
Work Location: Providence St Peter Hospital-Olympia
Workplace Type: On-site
Pay Range: $46.30 - $91.32
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
PandoLogic. Category:Healthcare, Keywords:Utilization Review Nurse, Location:Lacey, WA-98509- ...The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining...SuggestedLocal area
$47.69 - $94.06 per hour
...Description The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing...SuggestedMinimum wageFull timeLocal areaShift workAfternoon shift$95 - $96 per hour
...department. As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a... ...required. What You Will Be Doing: Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable...SuggestedFull timePart timeWork at officeImmediate start$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical... ...Must hold Compact Registered Nurse (RN) license in your state of residence. Greater... ...experience in utilization management/utilization review for a health plan or acute care setting....SuggestedBi-weekly payFull timeTemporary workApprenticeshipRemote workHome office$19 - $25 per hour
...policy. Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage.... ...self-care under the supervision of RN. Staff Related ~ Assists in training... ...application in an accurate and timely manner. Review treatment sheets for completeness, ensure...SuggestedHourly payWork experience placementImmediate start$33.89 - $56.49 per hour
...according to facility policy. · Prepares, organizes, and efficiently utilizes supplies and equipment to prevent waste. Clerical &... ...designated clinical application accurately and in a timely manner. · Reviews health care record for completeness and ensures omitted entries...Hourly payWork experience placementImmediate startFlexible hours$47.69 - $94.06 per hour
...Description The Inpatient Registered Nurse (RN) Care Manager provides professional, comprehensive, patient centric... ...assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation of interventions, regulatory...Daily paidMinimum wageFull timeLocal areaShift work$38.9 - $60.54 per hour
...Provides professional nursing care by utilizing the nursing process, implementing palliative... ...and supervisors; attends IDG meetings to review and update Plans of Care. Fulfills accepted... ...(Vendor Managed) Active state RN license (Vendor Managed). State Specific...Full timeFlexible hoursDay shift$54.1k - $155.54k
...Case Management, Disease Management and Utilization Management. AHH delivers flexible medical... ...their care. Perform medical necessity reviews. Required Qualifications ~5+ years’... ...year in a hospital setting. ~ The AHH RN Case manager position requires the nurse...Hourly payFull timeLocal areaRemote workWork from homeFlexible hours$38 - $51 per hour
...Select Home Care as a Registered Nurse (RN), where you'll bring comfort and confidence... ...home health strategies and procedures utilizing community resources as applicable Observes... ...in clinical record/utilization review of medical records and quality assurance...Weekly payDaily paidFull timePart timeReliefImmediate startFlexible hoursNight shiftWeekend workWeekday work- ...A healthcare company is seeking a Utilization Management Registered Nurse to coordinate medical services and benefit determinations. The role involves using clinical skills to interpret criteria, communicating with providers and members, and ensuring members receive appropriate...Remote work
$46.3 - $91.32 per hour
...conditions for payment. The Inpatient Registered Nurse (RN) Care Manager provides professional, comprehensive,... ...assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation of interventions, regulatory...Full timeLocal areaShift work- ...and objective medical data. Perform physical examinations, review of systems and current health and prevention indicators to diagnose... ...forms for billing, data entry or other reporting requirements utilizing the current Electronic Health Record system. Perform client...Work at officeMonday to FridayShift work
$78.97k - $131.61k
...discharge process to implement an effective treatment plan. Collect, review, and complete pre‑admission information and secure related sign‑... ...Education and Experience Requirements Licensed Registered Nurse (RN) or licensed Pharmacist in the state of practice with at least 2...Flexible hours$1,708 - $1,910 per week
...Registered Nurse (RN) | Operating Room Location: Olympia, OR Agency: Prime Time Healthcare Pay: $1,708 to $1,910 per week Shift Information: Rotating - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About the Role: Prime...Full timeContract workSummer workImmediate startShift workRotating shift$1,708 - $1,910 per week
...Registered Nurse (RN) | Operating Room Location: Olympia, OR Agency: Prime Time Healthcare Pay: $1,708 to $1,910 per week Shift Information: Rotating - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About the Role: TravelNurseSource...Full timeContract workTemporary workPart timeSummer workImmediate startShift workRotating shift$70.1k - $95k
...Payments: Design and administration of Medicaid cost reports, desk reviews and audits, and modeling of supplemental payment programs such... ...of provider reimbursement methodologies, including cost and utilization analysis and documentation to support regulatory and federal...For contractorsH1bWork at officeLocal area$90k
...standards according to organizational protocols.Reviews and analyzes clinic and organizational... ...or monthly as directed by performance.Utilizes the nursing model of identifying,... ...accredited college or university with an active RN license in the state of Washington.· LPNs...Full timeLocal area$2,400 - $10,000 per month
...messaging systems, and cloud-based documentation tools This company utilizes E-Verify. ComplexCare Solutions (CCS) is proud to be an equal... ...coding practices Complete comprehensive, accurate and thorough review of the assigned member population, including timely completion...Daily paidLocal areaRemote work$96.8k - $150.3k
...with Compassus Position Summary The Clinical Liaison RN (Exempt) - PAH is responsible for modeling the Compassus values... ...care information/education at meetings with hospital service, utilization review/discharge planners/case managers, patients and patient's families...Full timeFlexible hours$46.54 - $72.26 per hour
Description Under the supervision of the FNE/SANE Supervisor and Sexual Assault Clinic Medical Director, with orders when necessary from the Emergency Department Provider, the Forensic Nurse Examiner follows protocols to provide independent, comprehensive care to ...Part timeLocal areaShift work$47.69 - $94.06 per hour
...Inpatient Registered Nurse (RN) Care Manager The Inpatient Registered Nurse (RN) Care Manager provides professional,... ...assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation of interventions, regulatory...Shift work$7,891 - $10,379 per month
..., appreciated, and responded to in ways that fully develop and utilize each person's talents and strengths. We are dedicated to recruiting... ...control strategies, and case management ~ Ability to create, review, and update clinical policy and standing orders ~ Experience...Full timeContract workWork at officeLocal areaRemote workMonday to FridayFlexible hoursWeekend work$47.69 - $94.06 per hour
...Description The Inpatient Registered Nurse (RN) Care Manager provides professional, comprehensive, patient centric care... ...assessment and planning, coordination of care, resource utilization management and/or review, discharge planning, documentation of interventions,...Hourly payLocal areaShift work- ...Care Manager RN Unit manager approved the option of either 8 hour or 10 hour shifts. Start date: ASAP. Shift is 5x8 HR, a 4... ..., Adult Medical. Manager/Unit: Shannon Burke/ 150087510001-UTILIZATION REVIEW WA PSPH OLYMPIA MAIN 2ND FLOOR Type of Facility: Short Term...Temporary workLocal areaImmediate startShift workWeekend work
- ...preventive care and oversight for optimal management of chronic conditions including the cardiovascular- kidney- metabolic syndrome. • Utilizes data and risk stratification to identify high risk patients to prioritize outreach and gap closure defined by best evidence •...RelocationShift work
$2,300 - $2,453 per week
...Registered Nurse (RN) | Home Health Location: Lacey, WA Agency: Host Healthcare Pay: $2,300 to $2,453 per week Shift... ...was rated #1 in Nursing Satisfaction by MIT Sloan Management Review. No matter if you want to explore the other side of the country...Full timeContract workLocal areaImmediate startShift work$146.4k - $155k
...preventive care and oversight for optimal management of chronic conditions including the cardiovascular- kidney- metabolic syndrome. • Utilizes data and risk stratification to identify high risk patients to prioritize outreach and gap closure defined by best evidence •...Contract workLocal areaRelocationShift work- ...measures are being addressed and will do so by doing thorough EHR reviews, working collaboratively with the Chronic Care Coordinators,... ...Reports any abnormal vital signs to the provider immediately. Utilizes aseptic (sterile) technique. Assists with ordering of...ApprenticeshipWork at officeImmediate start
$46.54 - $72.26 per hour
..., as data controller, through the Employer’s data processor SonicJobs. See Providence Health and Services Terms & Conditions at utility-pages/privacy-policy#terms-of-use and Privacy Policy at utility-pages/privacy-policy#privacy-policy and SonicJobs Privacy Policy at...Minimum wagePart timeLocal areaShift work
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