Senior Service Engineer IS - Hybrid Providence St. Joseph HealthSenior Service Engineer IS - HybridSeattle, WARemoteFull timeProvidence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. In this role, you'll partner with endpoint engineering, service desk, and application teams to design, scale, and run Nexthink as a core enterprise service-turning endpoint telemetry into actionable insights, automation, and measurable outcomes.
Utilization Review RN - Remote Providence St. Joseph HealthUtilization Review RN - RemoteRenton, WARemoteFull timeProvidence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. The RN Care Coord-Qual Med Mgmt will provide administration of medical management programs that include: prior authorization, concurrent hospital and skilled nursing review, appeals and grievance, delegation, medical policy development and medical claims audits.
RN Case Manager- IKC National Flex Team- Remote DaVitaRN Case Manager- IKC National Flex Team- RemoteFederal Way, WARemoteFull timeOur more than 600 dedicated nurses, care coordinators, nurse practitioners (NPs) and business professionals integrate and manage care for more than 20,000 patients with late-stage chronic kidney disease (CKD) and end stage renal disease (ESRD) across the US each month. DaVita Integrated Kidney Care (DaVita IKC) is an the integrated care division of DaVita Inc. working on DaVita's vision to provide integrated care to all ESRD patients, who are some of the most medically complex and vulnerable patient populations in the US.
PRN/RN Patient Trainer/Medical Device AMERICAN CYBERSYSTEMS INC.PRN/RN Patient Trainer/Medical DeviceLynden, WARemoteFull timePatient Trainers go into patients' homes and train them on how to use INR (international normalized ratio, blood test) monitoring machines. It is used to test clotting times in people taking warfarin (a medicine used to treat and prevent blood clots).
FinOps Lead - Hybrid Cloud & On-Prem Infrastructure (Remote) GovCIOFinOps Lead - Hybrid Cloud & On-Prem Infrastructure (Remote)Olympia, WARemote$200,000–$225,000 / yearWhat You Can Expect** **Interview & Hiring Process** If you are selected to move forward through the process, here's what you can expect: + During the Interview Process + Virtual video interview conducted via video with the hiring manager and/or team + Camera must be on + A valid photo ID must be presented during each interview + During the Hiring Process + Enhanced Biometrics ID verification screening + Background check, to include: + Criminal history (past 7 years) + Verification of your highest level of education + Verification of your employment history (past 7 years), based on information provided in your application **Employee Perks** At GovCIO, we consistently hear that meaningful work and a collaborative team environment are two of the top reasons our employees enjoy working here. United States Suitability/Public Trust Fully remote IT Infrastructure & Network Engineering & Operations **Overview** GovCIO is seeking an experienced FinOps Lead with deep expertise in cloud financial management, IT financial operations, cost optimization, forecasting, and hybrid infrastructure cost governance to support the Department of Veterans Affairs (VA) Office of Information Technology (OIT).
NewInsurance Sales Representative (Remote/Hybrid | Local Territory) The Compass Business GroupInsurance Sales Representative (Remote/Hybrid | Local Territory)Clarkston, WashingtonRemoteOur mission-driven team thrives on service, integrity, and results empowering you to make a meaningful impact while building a successful career. At Compass Business Group , we help protect families, teams, and small businesses through supplemental insurance solutions.
Physician - Hybrid Radiologist (Onsite + Teleradiology) - Onsite/Remote - Washington MedAtlantic Healthcare SolutionsPhysician - Hybrid Radiologist (Onsite + Teleradiology) - Onsite/Remote - WashingtonSeattle, WashingtonRemoteIf you’re not interested but have a colleague who might be, MedAtlantic offers a lucrative referral bonus if you refer a colleague that would like more information. • Collaborating with referring doctors, specialists, and healthcare team members.
Senior Service Engineer IS - Hybrid Providence Health & ServicesSenior Service Engineer IS - HybridSpokane, WARemoteRequsition ID: 433029 Company: Providence Jobs Job Category: Development/Engineering Job Function: Information Technology Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Business Professional Department: 4011 SS IS ESI ENDPOINT ENG Address: OR Portland 5050 NE Hoyt St Work Location: Providence Professional Plaza Portland-Portland Workplace Type: Hybrid Pay Range: $See Posting - $See Posting 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 Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Senior Service Engineer - End User Compute, Hybrid Providence Health & ServicesSenior Service Engineer - End User Compute, HybridSpokane, WARemoteRequsition ID: 438183 Company: Providence Jobs Job Category: Development/Engineering Job Function: Information Technology Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Business Professional Department: 4011 SS IS ESI ENDPOINT ENG Address: OR Portland 5050 NE Hoyt St Work Location: Providence Professional Plaza Portland-Portland Workplace Type: Hybrid Pay Range: $See Posting - $See Posting 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. Service Engineers ensure caregivers have a fast, reliable, and frustration‑free digital experience by owning and operating our endpoint management platforms, including Microsoft Configuration Manager/SCCM, Microsoft Intune, and Jamf.
IT Services Sales Executive (Healthcare Payer Vertical) - REMOTE NTT America, Inc.IT Services Sales Executive (Healthcare Payer Vertical) - REMOTESeattle, WARemote$108,500–$250,000 / yearAdditional Qualifications and Responsibilities** + Sells complex managed services, full IT Outsourcing solutions, application services, and industry vertical solutions to include things like regulatory compliance solutions, digital solutions, mobile solutions, transformational services and application management/support, digital workplace services, Business Process Outsourcing (BPO), etc + History of success in a sales hunter role with a demonstrated ability to acquire net new logos + A passion for improving healthcare and patient outcomes and recognized as an expert in the Healthcare Payer/Payvider service solutions industry/industries + Deep understanding of IT managed and professional services and ability to articulate the value proposition to clients + Creatively sell into large national Healthcare Insurance and Provider accounts and ability to demonstrate successful deal closures + Requires strategic agility to interface and successfully influence C-level executives within the customer organization + Design and implement sales strategy to achieve sales quota + Ability to assess potential sales opportunities and develop value propositions + Applies an extremely deep understanding of business, financials, service offerings, the market, and the needs/challenges of assigned accounts + Understands and applies long-term vision of business/technology direction for NTT DATA + Drives services sales strategies that help drive exponential sales growth + Demonstrated ability & success at meeting and/or exceeding annual quotas of $12+ million in Revenue + Understanding of the competitive landscape for IT services and anticipates how market and competitive factors will influence the selling of NTT DATA services + Excellent written and verbal communication skills and demonstrates boardroom executive presence + Ability and willingness to travel 40% of the time **Basic Qualifications:** + Bachelor's degree + Minimum of 7 years of experience in IT Services sales and/or professional services sales + Minimum of 5 years of experience selling into enterprise Healthcare Payer clients **About NTT DATA** NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We deliver tangible business results by combining deep industry expertise with applied innovations in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services.
IT Sales/Managed Services Sr Sales Executive - Healthcare Payer (Remote Seattle) NTT America, Inc.IT Sales/Managed Services Sr Sales Executive - Healthcare Payer (Remote Seattle)Seattle, WARemoteAdditional Qualifications and Responsibilities** + Sells complex managed services, full IT Outsourcing solutions, application services, and industry vertical solutions to include things like regulatory compliance solutions, digital solutions, mobile solutions, transformational services and application management/support, digital workplace services, Business Process Outsourcing (BPO), etc + History of success in a sales hunter role with a demonstrated ability to acquire net new logos + A passion for improving healthcare and patient outcomes and recognized as an expert in the Healthcare Payer/Payvider service solutions industry/industries + Deep understanding of IT managed and professional services and ability to articulate the value proposition to clients + Creatively sell into large national Healthcare Insurance and Provider accounts and ability to demonstrate successful deal closures + Requires strategic agility to interface and successfully influence C-level executives within the customer organization + Design and implement sales strategy to achieve sales quota + Ability to assess potential sales opportunities and develop value propositions + Applies an extremely deep understanding of business, financials, service offerings, the market, and the needs/challenges of assigned accounts + Understands and applies long-term vision of business/technology direction for NTT DATA + Drives services sales strategies that help drive exponential sales growth + Demonstrated ability & success at meeting and/or exceeding annual quotas of $12+ million in Revenue + Understanding of the competitive landscape for IT services and anticipates how market and competitive factors will influence the selling of NTT DATA services + Excellent written and verbal communication skills and demonstrates boardroom executive presence + Ability and willingness to travel 40% of the time **Basic Qualifications:** + Bachelor's degree + Minimum of 7 years of experience in IT Services sales and/or professional services sales + Minimum of 5 years of experience selling into enterprise Healthcare Payer clients About NTT DATA NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We deliver tangible business results by combining deep industry expertise with applied innovations in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services.
Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEVancouver, WARemoteRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years of health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
NewCommercial Account Executive - Healthcare Zoom Communications IncCommercial Account Executive - HealthcareWARemoteWe set out to build the best collaboration platform for the enterprise, and today help people communicate better with products like Zoom Contact Center, Zoom Phone, Zoom Events, Zoom Apps, Zoom Rooms, and Zoom Webinars. As part of our award-winning workplace culture and commitment to delivering happiness, our benefits program offers a variety of perks, benefits, and options to help employees maintain their physical, mental, emotional, and financial health; support work-life balance; and contribute to their community in meaningful ways.
Breast Imaging Radiologist | 100% Breast + Breast MR | Hybrid/Remote Flexibility | No Call Radiology PartnersBreast Imaging Radiologist | 100% Breast + Breast MR | Hybrid/Remote Flexibility | No CallSpokane, WARemote$525,000–$575,000 / yearAdditionally, we will not send checks for deposit into your bank account at any stage of recruitment.?All communication during the interview and hiring process should come from an email address ending in “@radpartners.com.”?If you suspect you are receiving a fraudulent job offer or solicitation from Radiology Partners or one of our local practices, please notify our Recruiting Team?at recruiting@radpartners.com. Using a proven healthcare services model, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve.
Child Psychiatrist (MD/DO) - Hybrid Remote UnitedHealth GroupChild Psychiatrist (MD/DO) - Hybrid RemoteEverett, WARemote$315,000–$450,000 / year
Senior Service Engineer - End User Computer, Hybrid Providence St. Joseph HealthSenior Service Engineer - End User Computer, HybridWARemoteIn this role, you'll partner with endpoint engineering, service desk, and application teams to design, scale, and run Nexthink as a core enterprise service-turning endpoint telemetry into actionable insights, automation, and measurable outcomes. When issues arise, you're the calm technical leader who uses real‑time endpoint data to quickly identify root cause, restore service, and ensure the fix sticks through durable automation and improved monitoring.
Hybrid Remote/Onsite Dietitian - Washington Compass Group North AmericaHybrid Remote/Onsite Dietitian - WashingtonSeattle, WARemote$40–$50 / hourThe company has earned significant recognition, including being named one of Modern Healthcare's "Top 100 Best Places to Work in Healthcare" for five consecutive years, and appearing on Training Magazine's Top 125 Organizations list for six straight years. Compass Group employs over 3,000 RDNs across the United States, making us one of the nation's largest employers of Dietitians in a variety of settings: Hospitals and healthcare systems.
Senior Cloud Engineer Hybrid @ Bellevue, WA or Remote @ Florida OfferUp IncSenior Cloud Engineer Hybrid @ Bellevue, WA or Remote @ FloridaWARemote$215,000–$240,000 / yearOne of the top local marketplace apps for local buyers and sellers in the U.S., OfferUp makes it easy for people to discover more of what they need-from great deals and secondhand goods to jobs, services, home rentals, and more-right in their own communities. Keep the SDLC fast and safe - build CI/CD pipelines and developer workflows (GitHub Actions, monorepo tooling, JFrog Artifactory), and maintain the backend "golden templates" and shared libraries the wider org builds on.
Claims Specialist - Hybrid Remote WA State Providence Health & ServicesClaims Specialist - Hybrid Remote WA StateSeattle, WARemoteRequsition ID: 435789 Company: Pacific Medical Jobs Job Category: Claims Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Admin Support Department: 3060 OTHER FISCAL SERVICES WA Address: WA Seattle 1200 12th Ave S Work Location: PACMED Admin Bh-Seattle Workplace Type: On-site Pay Range: $21.55 - $33.53 Our strong team environment and respect for our people-at all levels and from all backgrounds-allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the Providence family, including local partners like Swedish Health Services.
Hybrid Remote BCBA Center for Social Dynamics IncHybrid Remote BCBASpokane, WARemote$80,000–$95,000 / yearWe've rebalanced service minimums to deliver greater flexibility, sustainable workloads, and real ownership over earning potential, while launching breakthrough clinical programs that strengthen outcomes for both families and clinicians. Stability & Innovation - Our model balances long‑term stability with thoughtful innovation, supporting clinicians with sustainable growth and evolving modalities that enhance clinical care - not disrupt it.
Hybrid Remote Licensed Assistant Behavior Analyst (LaBA) Center for Social Dynamics IncHybrid Remote Licensed Assistant Behavior Analyst (LaBA)Arlington, WARemote$32–$40 / hour2+ years of related professional experience implementing behavior modification intervention services OR 1 year of related professional experience implementing behavior modification intervention services and 12 semester units in applied behavior analysis OR you are a Board-Certified associate Behavior Analyst. As a fast-growing leader in the field, we're known for our vibrant culture, hands-on training, and career pathways that help you grow just as much as those we serve.
UM BH Registered Nurse HumanaUM BH Registered NurseOlympia, WARemoteUse your skills to make an impact** **Required Qualifications:** + **You must be a transitioning service member eligible to participate in the DOW SkillBridge or a military spouse eligible to participate in the military spouse fellowship** · + Active Registered Nurse, RN, in the state of Kentucky or an enhanced Compact, (eNLC) license without restrictions or disciplinary action.· + **Minimum two, (2) years of clinical behavioral health experience.** + Proficiency in healthcare software and electronic medical records (EMR) systems. **Workstyle:** Remote Work at Home **Location:** Must reside in a state that participates in the enhanced compact license, (eNLC) **Work Schedule:** Weekdays 8:00 AM to 4:30 PM Central Time **Travel:** None **Additional Information** **Work At Home Requirements** + WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office.
NewRegistered Nurse / RN (Oncology) Macpower Digital Assets Edge Private LimitedRegistered Nurse / RN (Oncology)Richland, WARemote$82,409–$164,736 / yearThis role supports patients through assessments, medication administration, monitoring, and coordinated care as part of a multidisciplinary healthcare team. Position Summary: The Oncology Registered Nurse provides compassionate, high-quality nursing care to patients undergoing cancer treatment.
Registered Nurse / RN, Home Health PRN AccentCare IncRegistered Nurse / RN, Home Health PRNTacoma, WARemote$113,210.97–$138,368.97 / hourThe Staff Nurse directs CHHAs and CNAs in patient care tasks, performs patient assessments, develops patient care plans, evaluates the plan effectiveness, modifies it as appropriate and documents all patient care provided. The position combines the activities of direct and indirect patient care and provides direct care to pediatric, adolescent, adult, and geriatric patients.
Registered Nurse/Utilization Review APN Consulting IncRegistered Nurse/Utilization ReviewEverett, WARemoteParking Cost: Facility PaidFacility Name: Providence Regional Medical Center Everett Colby Campus. Observed Holidays: New Year's Day: Falls Within: 12:00 AM day of - 12:00 AM day after.
Registered Nurse/Utilization Review IMCS Group IncRegistered Nurse/Utilization ReviewEverett, WARemoteTotal Staffed Beds: 571 total for both campuses. Will this traveler need to float between like units?
RN Case Manager – Managed Care REMOTE TEEMA GroupRN Case Manager – Managed Care REMOTELakewood, WARemote$39–$41Care Coordination : Work closely with interdisciplinary teams, including physicians, case managers, social workers, and other healthcare professionals, to develop and implement individualized care plans for patients. This role involves assessing, monitoring, educating, and supporting patients in managing their diseases to improve overall health and quality of life while reducing unnecessary hospitalizations and emergency care.
Revenue Cycle Auditor RN - Full time, Day, Remote Providence Health & ServicesRevenue Cycle Auditor RN - Full time, Day, RemoteWARemoteRequsition ID: 437237 Company: Providence Jobs Job Category: Revenue Cycle Operations Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Nursing Department: 4001 SS RC REV INTEGRITY Address: OR Portland 4400 NE Halsey St Work Location: Providence Health Plaza (HR) Bldg 1-Portland Workplace Type: On-site Pay Range: $See Posting - $See Posting 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 Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
State Hospital Liaison Community Health Plan of WashingtonState Hospital LiaisonSeattle, WARemoteThe Civil Commitment/State Hospital Liaison position is responsible for providing services to Community Health Plan of Washington (CHPW) members transitioning to and from State Hospitals and Long Term Civilly Committed (LTCC) behavioral health (BH) beds, and other inpatient psychiatric facilities. Travel to and meet with members hospitalized at the State Hospitals, LTCC and civilly committed to community hospitals for assessment, treatment planning, diversion, and discharge planning.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Seattle, WARemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
RN Health Care Facility Surveyor Impact Recruiting SolutionsRN Health Care Facility SurveyorBellevue, WashingtonRemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
Licensed Practical Nurse U.S. Department of Veterans AffairsLicensed Practical NurseSeattle, WARemote$55,480–$86,393 / yearGS-04: Six months of qualifying experience as an LPN or LVN; OR Graduation from an approved school (which may be waived as provided in paragraph 4 of Section C) and one year of experience that involved nursing care work in a hospital, outpatient clinic, nursing home, or other supervised medical, nursing, or patient care facility that provided a practical knowledge of human body structure and sterile techniques and procedures; OR Graduation from an approved school of at least 24 months duration. Knowledge and skill in performing support duties for complex diagnostic tests and/or specialized practices or procedures, which include preparing the patient, assisting in the diagnostic examination, preparing and handling specialized instruments or other specialized equipment, and monitoring the patients condition before, during, and following the procedure.
Director, Medical Document Optimization TriWest Healthcare AllianceDirector, Medical Document OptimizationSeattle, WARemoteFull timeLeadership: Ability to set strategic direction and translate organizational goals into operational plans; successfully leads and develops staff across varying styles and levels; provides clear expectations, effective coaching, and timely feedback; leads through a subordinate manager and drives accountability at all levels of the department. Problem Solving / Analysis: Ability to solve complex operational and systems-related problems through systematic analysis of data, workflows, and processes; exercises sound judgment in ambiguous or high-stakes situations; identifies root causes and implements durable solutions with a realistic understanding of organizational constraints.
NewUtilization Review Clinician - Behavioral Health Centene Corporation GroupUtilization Review Clinician - Behavioral HealthWARemote$27.02–$48.55 / hourPerforms prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria. Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.
(RN) Care Manager- Jail Transition Re-entry Program (REMOTE) Molina Healthcare Inc(RN) Care Manager- Jail Transition Re-entry Program (REMOTE)Seattle, WARemoteCompletes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
(RN) Remote Care Manager - CA License req Molina Healthcare(RN) Remote Care Manager - CA License reqEverett, WARemote$30.37–$61.79 / hourEssential Job Duties** - Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. - Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
Per Diem Medical Assistant Certified - Call Assist - Remote UnitedHealth GroupPer Diem Medical Assistant Certified - Call Assist - RemoteEverett, WARemote$16.15–$28.80 / hourAssists in the coordination of clerical information necessary to provide patient care i.e. referrals, assisting patients with appointments, assists patients with the arrangement of tests and treatments prescribed by physician or registered nurse. The Medical Assistant serves the patient and the provider by gathering and maintaining the necessary medical information in a cheerful, friendly, personable manner; providing quality patient care.
Primary Care Advanced Practice Provider (NP OR PA) Devoted Health IncPrimary Care Advanced Practice Provider (NP OR PA)WARemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
VP, Physician Review and Market Insights HumanaVP, Physician Review and Market InsightsOlympia, WARemoteDirect reports include:** **VP, Physician Leadership** **Clinical contracting, physician review, quality improvement, legal MDs** **Director, Physician Leadership** **MD vendors, grievance and appeals** **AVP, UM Nursing** **UM RNs (transplant, behavioral health, appeals, etc.)** **Lead Dental Director** **Dental MD/RN review, bid season benefit review** **Director, Strategy Advancement** **Market liaison, provider/facility relationships** **AVP, UM Administration** **UM intake, vendor management, administrative support** **Role Impact:** - Drive the formation, execution, and sustainability of Humana's Utilization Management strategy. This executive role is responsible for integrating and overseeing all Outpatient and Inpatient based MDs and RNs and non-clinical support for UM functions in Medicaid and Medicare, with a focus on streamlining processes, ensuring consistent clinical practices, driving trend savings, improving Star Ratings, and enhancing operational efficiency.
Complex Case Manager RN (Remote) Highmark HealthComplex Case Manager RN (Remote)Olympia, WARemoteExcellent organizational, time management and project management skills + Self-directed; self-starter, ability to work successfully with indirect supervision and moderate autonomy **LANGUAGE REQUIREMENT (Other than English)** None **TRAVEL REQUIREMENT** 0% - 25% **PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS** **Position Type** Office-Based Teaches/Trains others regularly Rarely Travels regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (Sales employees) Does Not Apply Physical Work Site Required No Lifting: up to 10 pounds Rarely Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. **EDUCATION** **Required** + High School Diploma/GED **Substitutions** + None **Preferred** + Bachelor's Degree in Nursing **EXPERIENCE** **Required** + 7 years of any combination of clinical, case management and/or disease/condition management experience, provider operations and / or health insurance experience **Preferred** + Advanced training and experience in cognitive behavioral therapy (CBT), motivational interviewing or dialectical behavior therapy (DBT) + Experience working with the healthcare needs of diverse populations + Understanding of the importance of cultural competency in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or NY is required.
Complex Case Manager RN - Specialty Pediatrics (Remote) Highmark HealthComplex Case Manager RN - Specialty Pediatrics (Remote)Olympia, WARemoteExcellent organizational, time management and project management skills + Self-directed; self-starter, ability to work successfully with indirect supervision and moderate autonomy **LANGUAGE REQUIREMENT (Other than English)** None **TRAVEL REQUIREMENT** 0% - 25% **PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS** **Position Type** Office-Based Teaches/Trains others regularly Rarely Travels regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (Sales employees) Does Not Apply Physical Work Site Required No Lifting: up to 10 pounds Rarely Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. **EDUCATION** **Required** + High School Diploma/GED **Substitutions** + None **Preferred** + Bachelor's Degree in Nursing **EXPERIENCE** **Required** + 7 years of any combination of clinical, case management and/or disease/condition management experience, provider operations and / or health insurance experience **Preferred** + Advanced training and experience in cognitive behavioral therapy (CBT), motivational interviewing or dialectical behavior therapy (DBT) + Experience working with the healthcare needs of diverse populations + Understanding of the importance of cultural competency in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or NY is required.
Field Nursing Operations Manager (West Coast) Science 37Field Nursing Operations Manager (West Coast)Seattle, WARemoteWith interest/expertise in Science 37's decentralized model of care delivery, the Field Nursing Operations Manager is responsible for the operational oversight, implementation and daily management of all nursing activities for clinical research studies within their region at Science 37. Through our solutions; Direct-to- Patient Site and Patient Recruitment, we accelerate enrollment by expanding the reach of clinical trials to patients beyond the traditional site and rigorously qualifying patients prior to referring them to a traditional site.
Registered Dietitian Part-Time (50% remote) RD Nutrition ConsultantsRegistered Dietitian Part-Time (50% remote)Tacoma, WARemoteRD Nutrition Consultants LLC is a leading Registered Dietitian Nutritionist Consulting firm that provides Dietitians to healthcare facilities across the United States. Conduct comprehensive nutritional assessments on new admissions and quarterly thereafter, with more frequent reviews as needed for high-risk residents.
Registered Dietitian Part -Time (50% remote) RD Nutrition ConsultantsRegistered Dietitian Part -Time (50% remote)Tacoma, WashingtonRemoteRD Nutrition Consultants LLC is a leading Registered Dietitian Nutritionist Consulting firm that provides Dietitians to healthcare facilities across the United States. Conduct comprehensive nutritional assessments on new admissions and quarterly thereafter, with more frequent reviews as needed for high-risk residents.
Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerSeattle, WARemoteFull timeo Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.
Chief of Staff to the Chief Operating Officer TriWest Healthcare AllianceChief of Staff to the Chief Operating OfficerSeattle, WARemoteFull timeTechnical Skills: Proficient in current trends in health care management with emphasis in customer service, network management, utilization and financial trends; collaboration skills to work with TriWest management team across multiple locations; networking skills with all levels, including subcontractors. • Works on multiple high level projects including logistical coordination, data analysis, contract management and written communications in support of various business initiatives of high visibility, applying project management tools and methodologies and leadership skills to meet or exceed deadlines.
Clinical Quality Study Analyst TriWest Healthcare AllianceClinical Quality Study AnalystSeattle, WARemoteFull timeTechnical Skills: General knowledge of Medicare, Veteran's Administration, TRICARE, or other government health care programs; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.