Clinical Care Coordinator, Utilization Management Specialist
1 day ago
Molina Healthcare Services (HCS) is dedicated to providing high-quality care to our members. As a Clinical Care Coordinator, you will play a critical role in assessing, facilitating, planning, and coordinating an integrated delivery of care across the continuum.
Responsibilities- Analyze clinical service requests from members or providers against evidence-based clinical guidelines.
- Identify appropriate benefits, eligibility, and expected length of stay for requested treatments and/or procedures.
- Conduct inpatient reviews to determine financial responsibility for Molina Healthcare and its members.
- Process requests within required timelines.
- Collaborate with multidisciplinary teams to promote the Molina Care Model.
- Graduate from an Accredited School of Nursing.
- 3+ years hospital acute care/medical experience.
- Active, unrestricted State Registered Nursing (RN) license in good standing.
- Valid driver's license with a good driving record.
- Bachelor's Degree in Nursing.
- Previous experience in Hospital Acute Care, ER, ICU, Prior Auth, Utilization Review/Utilization Management, and knowledge of Interqual/MCG guidelines.
- Utilization Management Certification (CPHM).
Molina Healthcare offers a competitive salary range of $41.18 - $83.22 per hour, based on location, work experience, education, and skill level. We are an Equal Opportunity Employer (EOE) and value diversity in our workplace.
-
Nurse Care Coordinator
3 weeks ago
Bellevue, Washington, United States Pacific Medical Centers Full timePacific Medical Centers is seeking a highly skilled and compassionate Care Manager RN to join our team. This rewarding role offers the opportunity to make a meaningful impact on patients' lives while working in a dynamic and collaborative environment.About the Role:The Care Manager RN will be responsible for coordinating care for Pacific Medical Centers'...
-
Clinical Care Specialist
3 weeks ago
Bellevue, Washington, United States Eating Recovery Center Full timeAbout ERC PathlightERC Pathlight is a leading clinical healthcare provider specializing in the treatment of eating disorders, mood and anxiety disorders, and trauma-related conditions. With over 30 facilities across seven states and extensive tele-healthcare services nationwide, we deliver comprehensive treatment programs to support patients in their...
-
Clinical Nurse Specialist
3 days ago
Bellevue, Washington, United States Overlake Hospital Medical Center Full timeJob Title: Clinical Nurse SpecialistLocation: Bellevue, WAJob Type: Full-timeAbout Us: Overlake Clinics, LLC (OC) is a healthcare leader in the region, committed to providing compassionate, high-quality patient care in a progressive and collaborative environment.Job Description: We are seeking a skilled Clinical Nurse Specialist to join our Concierge Clinic...
-
Animal Care Specialist
3 days ago
Bellevue, Washington, United States Pet Care Clinic Full timeJob OverviewWe are seeking a compassionate Animal Care Specialist to join the team at Pet Care Clinic. As a key member of our clinic staff, you will play a vital role in ensuring the health and well-being of all our pet patients.
-
Clinical Informatics Coordinator
5 days ago
Bellevue, Washington, United States Insight Global Full timeWe are seeking a dedicated and detail-oriented Clinical Informatics Coordinator to join Insight Global's dynamic healthcare team.Job SummaryThis role is essential in bridging the gap between clinical practice and information technology, ensuring that our healthcare systems effectively support patient care and clinical operations.Key ResponsibilitiesActive WA...
-
Healthcare Professional
3 weeks ago
Bellevue, Washington, United States Swedish Health Services Full timeSwedish Health Services is seeking a skilled Nurse Care Coordinator to join our team. As a key member of our care management team, you will play a vital role in coordinating patient care and services across the healthcare continuum.With a strong foundation in nursing, you will work collaboratively with inter-disciplinary teams to ensure seamless transitions...
-
Patient Care Coordinator
1 week ago
Bellevue, Washington, United States Swedish Health Services Full timeCompany Overview:Swedish Health Services is a leading healthcare provider in the greater Puget Sound area, with a commitment to delivering high-quality patient care and improving the well-being of our communities.Salary: $74,610 per yearJob Description:Patient Care Coordinator Role SummaryThe Patient Care Coordinator plays a vital role in coordinating the...
-
Care Manager RN Professional
3 weeks ago
Bellevue, Washington, United States Pacific Medical Centers Full timeOverview">Pacific Medical Centers is a comprehensive healthcare organization dedicated to providing exceptional care to patients across various settings.">Salary">$67,235 - $103,049 per year, including competitive pay, shift differentials, and bonuses for this full-time Care Manager RN position in Seattle, WA. ">Job Description">The ideal candidate will...
-
Bellevue, Washington, United States Swedish Health Services Careers Full timeSwedish Health Services CareersSalary Range: $53,040 - $83,950 per yearAbout the Job:This is a full-time opportunity as a Clinical Education Specialist for Nursing Development with Swedish Health Services Careers in Seattle, Washington. The salary range for this role is $53,040 - $83,950 per year.Job Summary:We are seeking a highly skilled and experienced...
-
Animal Health Care Specialist
3 weeks ago
Bellevue, Washington, United States Pet Care Clinic Full timeWe are a leading veterinary clinic committed to delivering exceptional patient care and promoting the well-being of pets. Our mission at Pet Care Clinic is built around recognizing the importance of the Human-Animal Bond, providing compassionate service, and upholding the highest standards of veterinary medicine.We seek highly skilled Licensed Veterinary...
-
Clinical Care Specialist
3 weeks ago
Bellevue, Washington, United States TotalMed Full timeExperience the Thrill of a Career in Clinical CareIn this esteemed role as a Clinical Care Specialist, you will form an integral part of our team at TotalMed. Salary: $2,391.75/week.You will be working in Bellevue, Washington, where you can expect to experience the serene beauty of nature and the innovative spirit of the Pacific Northwest. This is an...
-
Clinical Utilization Manager
1 day ago
Bellevue, Washington, United States Molina Healthcare Full timeAbout the RoleIn this critical position, you will work closely with multidisciplinary teams to promote Molina's Care Model. You will analyze clinical service requests, conduct inpatient reviews, and collaborate with medical directors to ensure optimal outcomes for our members.",
-
Clinical Care Coordinator
7 days ago
Bellevue, Washington, United States Kaiser Permanente Full timeJob SummaryKaiser Permanente seeks a skilled Registered Nurse to provide on-call nursing care to patients in the ambulatory setting. As an integral member of the healthcare team, you will coordinate and facilitate healthcare services for patients, providing ongoing assessment and implementation of care plans.Essential Responsibilities:Nursing Care Planning:...
-
Clinical Care Coordinator
3 weeks ago
Bellevue, Washington, United States Reproductive Medicine Associates (RMA Network) Full timeJoin Our Team: As a Registered Nurse with Reproductive Medicine Associates (RMA Network), you will be part of a dedicated team of professionals committed to delivering exceptional patient care. Our goal is to help individuals and couples achieve their reproductive goals through comprehensive fertility solutions.Salary: The estimated annual salary for this...
-
Clinical Care Specialist
7 days ago
Bellevue, Washington, United States Providence Health & Service Full timeJob Overview: Swedish Health Services is seeking a skilled Registered Nurse to join our team at the Puget Sound area in Washington. As a Clinic RN, you will provide high-quality patient care under the direction of our experienced supervisors and managers.About the Role: Our ideal candidate has a strong foundation in nursing practices, excellent communication...
-
Nurse Care Coordinator
3 weeks ago
Bellevue, Washington, United States Swedish Health Services Full timeOverview">Swedish Health Services is a not-for-profit health care system in the greater Puget Sound area, comprised of eight hospital campuses, emergency rooms, and specialty centers. We are dedicated to improving the wellbeing of rural and urban communities by expanding access to quality health care for all.">Salary Range">$47.13 - $74.61 per hour">Job...
-
Vision Care Specialist
19 hours ago
Bellevue, Washington, United States SharpeVision Full timeAbout UsAt SharpeVision, we believe in empowering our patients to achieve their full potential by offering cutting-edge vision correction solutions. Our mission is to provide personalized care, exceptional service, and unparalleled results, setting us apart from other vision correction centers.Salary Range: $50,000 - $60,000 per yearJob RoleWe are looking...
-
Perioperative Care Coordinator
1 day ago
Bellevue, Washington, United States Surgery Care Affiliates Full timeSurgery Care Affiliates is seeking a skilled Perioperative Care Coordinator to join our team. In this role, you will be responsible for assessing patient status throughout the perioperative episode of care and developing an individualized perioperative patient plan of care.Key Responsibilities:Assess patient status throughout the perioperative episode of...
-
Supportive Care Specialist
3 weeks ago
Bellevue, Washington, United States Redwood Family Care Network Full timeAs a member of the Redwood Family Care Network team, you will play a vital role in providing supportive care to individuals with intellectual and developmental disabilities.The hourly rate for this position is estimated at $23.50-$26.25 per hour, based on industry standards and location factors.Job ResponsibilitiesUnder the supervision of the House Manager,...
-
Care Coordinator for Supported Living Services
3 weeks ago
Bellevue, Washington, United States Redwood Family Care Network Full timeAt Redwood Family Care Network, we are dedicated to delivering exceptional person-centered home and community-based services to individuals with intellectual and developmental disabilities. As a Care Coordinator for Supported Living Services, you will play a vital role in monitoring the overall medical coordination of our clients.The ideal candidate will...