utilization management nurse

Elevance Health

<div>
 
 Location:
 
 This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
 
 
 Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
 
 
 A proud member of the Elevance Health family of brands, Carelon Health (formerly CareMore Health) offers clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.
 
 
 
 Work Hours:
 
 Monday - Friday (9:30 AM -6:00 PM Centeral)
 
 
 The
 
 Nurse Reviewer I
 
 is responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. Collaborates with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with more senior colleagues to complete non-routine reviews. Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request to assess assessing the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment.
 
 
 
 How You Will Make An Impact
 
 
 
 
 Primary duties may include, but are not limited to:
 
 
 
 <ul>
 <li>
 Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
 </li>
 <li>
 Conducts initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan network.
 </li>
 <li>
 Notifies ordering physician or rendering service provider office of the preauthorization determination decision.
 </li>
 <li>
 Follows-up to obtain additional clinical information.
 </li>
 <li>
 Ensures proper documentation, provider communication, and telephone service per department standards and performance metrics.
 </li>
 <li>
 Other duties as assigned
 
 
 </li>
 </ul>
 
 Minimum Qualifications
 
 
 
 Requires AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license in applicable state(s) required.
 
 
 
 Preferred Skills, Capabilities And Experiences
 
 
 
 <ul>
 <li>
 Familiarity with Utilization Management Guidelines is preferred
 </li>
 <li>
 ICD-9 and CPT-4 coding, and managed health care including HMO, PO and POS plans strongly preferred.
 </li>
 <li>
 BA/BS degree preferred.
 </li>
 <li>
 Previous utilization and/or quality management and/or call center experience preferred.
 </li>
 <li>
 Proficiency in Microsoft Office Products is strongly preferred
 
 
 </li>
 </ul>
 For candidates working in person or virtually in the below locations, the salary* range for this specific position is $34.69 to $54.41 (hourly)
 
 
 
 Location(s):
 
 California, Illinois, Minnesota
 
 
 In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
 
 
 <ul>
 <li>
 The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company&rsquo;s sole discretion, consistent with the law.
 
 
 </li>
 </ul>
 Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
 
 
 Who We Are
 
 
 Elevance Health is a health company dedicated to improving lives and communities &ndash; and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
 
 
 How We Work
 
 
 At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
 
 
 We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
 
 
 Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
 
 
 The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
 
 
 Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
 
 
 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
</div>

Nurse Reviewer I

Centene Corporation

<div>
 You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 
 
 <ul>
 <li>
 POSITION IS REMOTE WITH POTENTIAL FOR WEEKENDS, HOLIDAYS AND ON-CALL***
 </li>
 <li>
 COMPACT LICENSE REQUIRED***
 
 
 </li>
 </ul>
 
 Position Purpose
 
 Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member.
 
 
 <ul>
 <li>
 Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate level of care
 </li>
 <li>
 Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay, and discharge planning of member
 </li>
 <li>
 Works with Medical Affairs and/or Medical Directors as needed to discuss member care being delivered
 </li>
 <li>
 Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines
 </li>
 <li>
 Works with healthcare providers to approve medical determinations or provide recommendations based on requested services and concurrent review findings
 </li>
 <li>
 Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members
 </li>
 <li>
 Provides feedback to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical policies and guidelines
 </li>
 <li>
 Reviews member&rsquo;s transfer or discharge plans to ensure a timely discharge between levels of care and facilities
 </li>
 <li>
 Collaborates with care management on referral of members as appropriate
 </li>
 <li>
 Performs other duties as assigned
 </li>
 <li>
 Complies with all policies and standards
 
 
 </li>
 </ul>
 
 Education/Experience
 
 Requires Graduate from an Accredited School of Nursing or Bachelor&rsquo;s degree in Nursing and 2 &ndash; 4 years of related experience. 2+ years of acute care experience required.
 
 
 Clinical knowledge and ability to determine overall health of member including treatment needs and appropriate level of care preferred.
 
 
 Knowledge of Medicare and Medicaid regulations preferred.
 
 
 Knowledge of utilization management processes preferred.
 
 
 
 License/Certification
 
 
 
 <ul>
 <li>
 LPN - Licensed Practical Nurse - State Licensure required
 
 
 </li>
 </ul>
 Pay Range $27.02 - $48.55 per hour
 
 
 Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
 
 
 Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
 
 
 Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
</div>

Clinical Review Nurse – Concurrent Review

Fidelis Care - New York

<div>
 You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 
 
 
 Work Location
 
 
 
 This is a remote position but candidates must hold active New York State licensure to be considered.
 
 
 
 Licensure Requirements
 
 
 
 Candidates must hold active New York State licensure to be considered.
 
 
 
 Registered Nurses located in the Buffalo, NY area are strongly preferred.
 
 
 
 
 Schedule
 
 
 
 This role follows a
 
 Monday&ndash;Friday, 830 AM&ndash;500 PM
 
 schedule with a one-hour assigned lunch break.
 
 
 
 Position Purpose
 
 Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.
 
 
 <ul>
 <li>
 Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and criteria
 </li>
 <li>
 Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care
 </li>
 <li>
 Coordinates as appropriate with healthcare providers and interdepartmental teams, to assess medical necessity of care of member
 </li>
 <li>
 Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness of care
 </li>
 <li>
 Assists with service authorization requests for a member&rsquo;s transfer or discharge plans to ensure a timely discharge between levels of care and facilities
 </li>
 <li>
 Collects, documents, and maintains all member&rsquo;s clinical information in health management systems to ensure compliance with regulatory guidelines
 </li>
 <li>
 Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to members
 </li>
 <li>
 Provides feedback on opportunities to improve the authorization review process for members
 </li>
 <li>
 Performs other duties as assigned
 </li>
 <li>
 Complies with all policies and standards
 
 
 </li>
 </ul>
 
 Education/Experience
 
 Requires Graduate from an Accredited School of Nursing or Bachelor&rsquo;s degree in Nursing and 2 &ndash; 4 years of related experience.
 
 
 <ul>
 <li>
 Clinical knowledge and ability to analyze authorization requests and determine medical necessity of service preferred.
 </li>
 <li>
 Knowledge of Medicare and Medicaid regulations preferred.
 </li>
 <li>
 Knowledge of utilization management processes preferred.
 </li>
 <li>
 NY RN license preferred.
 
 
 </li>
 </ul>
 
 License/Certification
 
 
 
 <ul>
 <li>
 LPN - Licensed Practical Nurse - State Licensure required
 </li>
 <li>
 For Health Net of California RN license required
 </li>
 <li>
 For Superior Health Plan RN license required
 
 
 </li>
 </ul>
 Pay Range $27.02 - $48.55 per hour
 
 
 Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
 
 
 Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
 
 
 Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
</div>

Clinical Review Nurse - Prior Authorization

Martha & Mary

<div><h2 class="jobSectionHeader">Case Manager / Admissions Nurse (RN or LPN)</h2>
Location: Martha &amp; Mary 
Status: Exempt | Full-Time 
Pay Range: $85,000 - $95,000 annually depending on applicable experience<h3 class="jobSectionHeader">
About Martha &amp; Mary</h3>
At Martha &amp; 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.<h3 class="jobSectionHeader">
Key Responsibilities</h3><h4 class="jobSectionHeader">
Care Coordination &amp; Clinical Oversight</h4><ul><li>
Coordinate and integrate case management and social service functions into individualized plans of care and discharge planning.</li><li>
Conduct medical record reviews, utilization reviews, and quality assessments from admission through discharge.</li><li>
Oversee direct provision of care and ensure evidence-based practices are delivered.</li><li>
Conduct Care Conferences, Warm Handovers, interdisciplinary rounds, and family conferences.</li><li>
Assist with admission assessments, orders, and paperwork per DNS direction.</li><li>
Coordinate admissions, discharges, transfers, and bed management with nursing leadership and admissions teams.</li><li>
Communicate with primary care providers, hospital partners, and external specialists throughout the resident stay.</li><li>
Initiate and present NOMNOC (denial) letters as appropriate.</li></ul><h4 class="jobSectionHeader">
Collaboration &amp; Communication</h4><ul><li>
Work closely with internal partners including Nursing Leadership, Social Work, Rehab Services, MDS, HIM, A/R, Therapists, and Operations.</li><li>
Collaborate with external stakeholders such as family members, hospitals, discharge planners, HMOs, physicians, home health agencies, and other providers.</li><li>
Serve as a resident and patient advocate, ensuring informed decision-making and family education.</li></ul><h4 class="jobSectionHeader">
Utilization, Compliance &amp; Quality</h4><ul><li>
Monitor RUG utilization, PDPM outcomes, and appropriate service use.</li><li>
Conduct reviews related to falls, wounds, medication errors, readmissions, pharmacy discrepancies, and other quality indicators.</li><li>
Ensure appropriate testing, timely results, and adherence to regulatory and payer requirements.</li><li>
Participate in weekly Case Management meetings and continuous quality improvement initiatives.</li></ul><h4 class="jobSectionHeader">
Leadership &amp; Supervision</h4><ul><li>
Provide day-to-day leadership, guidance, and supervision to Licensed Nurses and NACs.</li><li>
Participate in hiring, performance management, coaching, and employee development in alignment with organizational values.</li><li>
Troubleshoot care concerns, complaints, and conflicts, escalating to DNS or Operations leadership as needed.</li></ul><h4 class="jobSectionHeader">
Additional Duties</h4><ul><li>
Perform medication destruction and disposal oversight.</li><li>
Assist nursing staff with care activities as needed.</li><li>
Perform all regular RN or LPN duties per licensure and job description.</li></ul><h3 class="jobSectionHeader">
General Expectations</h3><ul><li>
Support and uphold Martha &amp; Mary&rsquo;s mission, vision, and values.</li><li>
Maintain confidentiality and professionalism at all times.</li><li>
Demonstrate reliability, flexibility, and strong teamwork.</li><li>
Manage multiple priorities in a fast-paced, changing environment.</li><li>
Approach challenges with initiative, diplomacy, and a sense of humor.</li><li>
Exhibit a genuine interest in caring for the elderly and long-term care residents.</li></ul><h3 class="jobSectionHeader">
Required Qualifications</h3>
Education<ul><li>
Associate Degree required</li><li>
Bachelor&rsquo;s Degree preferred</li></ul>
Licensure<ul><li>
Current RN or LPN license in the State of Washington (required)</li></ul>
Experience<ul><li>
Sub-acute care or Skilled Nursing experience preferred</li></ul>
Knowledge, Skills &amp; Abilities<ul><li>
Strong knowledge of Medicare, HMO contracts, MDS, PDPM utilization, and evidence-based practices</li><li>
Exceptional communication and customer service skills</li><li>
Highly organized with strong documentation abilities</li><li>
Ability to collaborate effectively with interdisciplinary teams</li><li>
Proficiency with MS Office Suite and healthcare systems including Answers on Demand, ADP, DocSTAR, FaxCORE, and mobile technology</li><li>
Ability to safely use medical devices and equipment</li></ul><h3 class="jobSectionHeader">
Why Join Martha &amp; Mary?</h3><ul><li>
Mission-driven, values-based culture</li><li>
Collaborative interdisciplinary team environment</li><li>
Opportunity to make a meaningful impact on resident and family experiences</li><li>
Competitive compensation and comprehensive benefits</li></ul>
Benefits:
Martha &amp; 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 &amp; Mary.<ul><li>
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&rsquo;s Paid Sick Leave Law</li><li>
40% discount on child care services while working</li><li>
Comprehensive benefit package after 60 days to include medical, dental, vision and life insurance options for full time employees.
</li><li>Career advancement opportunities across multiple sites and departments</li><li>
403(b) Retirement Savings Plan is available immediately upon hire</li><li>
5 Paid Holidays</li><li>
Employee Assistance and Counseling for life&rsquo;s challenges outside of the workplace</li><li>
Cell phone, Health Club and Auto service discounts</li><li>
And much more</li></ul>
Martha &amp; Mary employee benefits and wages offered are reviewed annually and are intended to be fair, beneficial and competitive in today&rsquo;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 &amp; Mary is an Equal Opportunity Employer. 
We celebrate diversity and are committed to creating an inclusive environment for all employees.</div>

Case Manager / Admissions Nurse (Licensed Nurse) - MArtha & Mary

Arcadia LTC

<div>MDS / Care Plan Coordinator

Registered Nurse RN or Licensed Practical Nurse LPN

Job Summary:

The MDS / Care Plan Coordinator is responsible for assuring the timely completion of accurate resident assessments and interdisciplinary care plans that meet Federal and State guidelines. This includes identifying resident acuity and needs, helping to determine specific care needs, and communicating needs and expectations to families and responsible parties.

Essential Duties:
<ul><li> Responsible for integrating nursing, dietary, social recreation, restorative, rehabilitation, and physician services to ensure appropriate assessment and reimbursement.</li></ul>
<ul><li> Responsible for completion of all Medicare/Medicaid case-mix documents to assure appropriate reimbursement for care and services provided within the Facility.</li></ul>
<ul><li> Conducts continual Minimum Data Set (MDS) reviews to assure achievement of optimal allowable Resource Utilization Group (RUG) category.</li></ul>
<ul><li> Oversees the overall process and tracking of MDS/Prospective Payment System (PPS) documentation and submission.</li></ul>

Benefits Offered:
<ul>
<li>Extremely low-cost Health, Dental, Vision, 401K, and more
</li>
<li>$25,000 Company Paid Life Insurance &ndash; at no cost to you
</li>
<li>Leadership Training to enhance your management skills
</li>
<li>Daily Pay - get your money when you want
</li>
<li>Paid Vacations - rolls over each year
</li>
<li>Paid Sick Time
</li>
<li>Paid Holidays
</li>
<li>Tuition Reimbursement
</li>
<li>Daily, Weekly, Monthly Employee Appreciation Events
</li>
<li>Birthday, Anniversary Celebrations
</li>
<li>Free Employee Assistance Programs - professional support &amp; guidance on family, money, health, legal services and more
</li>
<li>Huge Discounts at all major retailers (Walmart, Costco, etc.) at no cost to you
</li>
<li>Virtual Visits with Doctors 24/7, without setting up additional accounts or appointments
</li>
<li>Paid Break Time for Nursing Mothers
</li>
<li>Time Off to Vote</li></ul> 

Preferred Qualifications:
<ul><li> Registered Nurse with current unencumbered state licensure.</li></ul>
<ul><li> Long Term Care Experience preferred.</li></ul>
<ul><li> Ability to read, write, speak, and understand the English language.</li></ul>

 #ACL NRS</div>

MDS Care Plan Nurse (RN/LPN)

King Faisal Specialist Hospital and Research Center

<div>
 
 The
 
 Talent Acquisition Team at Building No. 20
 
 , a
 
 secondary care hospital that is proudly part of the King Faisal Specialist Hospital &amp; Research Centre (KFSHRC)
 
 , is delighted to announce a range of
 
 exciting new opportunities
 
 at our
 
 Riyadh facility
 
 .
 
 
 As a valued part of the KFSHRC,
 
 Building No. 20
 
 plays an essential role in delivering
 
 high-quality, patient-centered care
 
 and supporting the hospital&rsquo;s mission of
 
 excellence, innovation, and compassion in healthcare
 
 .
 
 
 
 
 
 Position
 
 
 
 Nursing Supervisor
 
 
 
 
 
 Location
 
 
 
 Building 20 - Riyadh, Saudi Arabia
 
 
 
 
 
 Employer
 
 
 
 KFSHRC (or one of its subsidiaries)
 
 
 
 
 
 Essential Responsibilities and Duties
 
 
 
 1. Represents Nursing Administration during evenings, nights, and weekends.
 
 
 2. Ensures appropriate utilization of nursing resources.
 
 
 3. Confers with charge person regarding patient acuity and/or staffing changes required. Determines staffing
 
 
 changes and approves overtime to provide for unplanned situations. Maintains an awareness of resource
 
 
 utilization, exercising care in the ordering and use of staff, equipment, and materials.
 
 
 4. Refers unit-specific occurrences or incidents to Head Nurse and/or Nursing Administration for follow up.
 
 
 5. Provides input to Head Nurse and/or Nursing Administration for staff performance evaluations. Advises,
 
 
 counsels and disciplines staff as required or requested.
 
 
 6. Responds to Code Green, Fire, and Disaster Drills.
 
 
 7. Prepares reports and maintains records.
 
 
 8. Observes and evaluates nursing care effectiveness on shift and communicates identified issues to Head
 
 
 Nurse and/or Nursing Administration.
 
 
 9. Participates in the promotion and maintenance of effective communication and teamwork.
 
 
 10. Actively welcomes new staff/students to the assigned area and participates in retention activities.
 
 
 Contributes to the retention of all staff to meet the assigned area specific turnover rate goal.
 
 
 11. Demonstrates collaborative multi-disciplinary partnerships working towards the achievements of constant
 
 
 improvement in quality patient care and the smooth running of out of hour&rsquo;s operations.
 
 
 12. Identifies ideas that will improve the quality of patient care and issues that will negatively impact on patient
 
 
 care outcomes, using the professional practice framework. Participates through team working and
 
 
 collaborative partnerships in identifying and implementing solutions through evidence based practice or
 
 
 research to demonstrate improvements reflected in unit, divisional, organizational data, and bench marks.
 
 
 13. Develops and sustains own knowledge, skills, and professional awareness and maintains a professional
 
 
 profile. Provides documented evidence of performance and maintenance of skills consistent with position.
 
 
 14. Contributes to the achievement of clinical quality outcome indicators and patient satisfaction. Participates
 
 
 in Performance Improvement activities as assigned. Contributes to special projects/assignments linked to
 
 
 nursing strategic priorities and professional practice model.
 
 
 15. Follow all Hospital related policies and procedures.
 
 
 16. Participates in self and other&rsquo;s education, training and development, as applicable.
 
 
 17. Performs other related duties as assigned.
 
 
 
 
 
 
 Job Requirements
 
 
 
 
 Education:
 
 Master&rsquo;s, or Bachelor&rsquo;s Degree in Nursing is required.
 
 
 
 Experience Required:
 
 Four (4) years of nursing experience with Master&rsquo;s, or six (6) years of with Bachelor&rsquo;s
 
 
 Degree is required.
 
 
 
 Other Requirements (Certifications):
 
 Current Registered Nurse Licensure from country of origin and Saudi Commission for Health Specialties Licensure is required.
 
</div>

Nursing Supervisor - Building 20

Providence Swedish

<div>Description
The Inpatient Registered Nurse (RN) Care Manager provides professional, comprehensive, patient centric care management services for at risk patients in an acute care environment. Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation of interventions, regulatory compliance and patient advocacy. The goal of the Inpatient Care Management RN is to ensure the use of appropriate healthcare resources throughout the continuum, so that the care provided is the right care, at the right time, in the right setting.
Providence caregivers are not simply valued &ndash; they&rsquo;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:
<ul><li>Associate's Degree Nursing degree/diploma upon hire</li>
<li>Upon hire: Washington Registered Nurse License</li>
<li>2 years Acute care experience in a Medical Surgical or Inpatient setting</li>
<li>IRR or annual competency testing in Utilization Review</li>
</ul>Preferred Qualifications:
<ul><li>Bachelor's Degree Nursing or higher within 3 years of hire</li>
<li>National Certification in area of specialty.</li>
<li>1 year experience in care management or utilization review in any setting or successful completion of TIPS program or Case Management Orientation Program</li>
</ul>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 &ldquo;Know me, care for me, ease my way.&rdquo; Working at our family of organizations means that regardless of your role, we&rsquo;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.
Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts 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.
Requsition ID: 408131
Company: Providence Jobs
Job Category: Care Management
Job Function: Clinical Care
Job Schedule: Part time
Job Shift: Multiple shifts available
Career Track: Nursing
Department: 3030 CASE MGMT WA SPH
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.</div>

RN - Care Manager

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