Concurrent Review RN
Tacoma, WA · On-site
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Interqual or Milliman experience Utilization review experience Case Management experience Hours for ...
Tacoma, WA · On-site
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Interqual or Milliman experience Utilization review experience Case Management experience Hours for ...
Tacoma, WA · On-site
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Interqual or Milliman experience Utilization review experience Case Management experience Hours for ...
... Utilization (Pharmacist 4). WORK SCHEDULE * Full-Time / 40 hours per week * Rotating/Variable ... Oversee process and content of medication use evaluation, formulary monographs and review documents ...
... Utilization (Pharmacist 4). WORK SCHEDULE * Full-Time / 40 hours per week * Rotating/Variable ... Oversee process and content of medication use evaluation, formulary monographs and review documents ...
Seattle, WA · On-site
$232K/yr
... Utilization (Pharmacist 4). WORK SCHEDULE * Full-Time / 40 hours per week * Rotating/Variable ... Oversee process and content of medication use evaluation, formulary monographs and review documents ...
Seattle, WA · On-site
$232K/yr
... Utilization (Pharmacist 4). WORK SCHEDULE * Full-Time / 40 hours per week * Rotating/Variable ... Oversee process and content of medication use evaluation, formulary monographs and review documents ...
... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... Builds collaborative relationships with pharmacy directors, clinical pharmacists, business analysts ...
... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... Builds collaborative relationships with pharmacy directors, clinical pharmacists, business analysts ...
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Review analyses of activities, costs, operations and forecast data to determine progress toward ...
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Review analyses of activities, costs, operations and forecast data to determine progress toward ...
Seattle, WA · On-site
$163 - $233/hr
... and Utilization (Pharmacist 4). Work Schedule Full-Time / 40 hours per week Rotating/Variable ... Oversee process and content of medication use evaluation, formulary monographs and review documents ...
Seattle, WA · On-site
$163 - $233/hr
... and Utilization (Pharmacist 4). Work Schedule Full-Time / 40 hours per week Rotating/Variable ... Oversee process and content of medication use evaluation, formulary monographs and review documents ...
Renton, WA · On-site
$19 - $23.50/hr
... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...
Renton, WA · On-site
$19 - $23.50/hr
... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...
Renton, WA · On-site
$18.75 - $23.25/hr
... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...
Renton, WA · On-site
$18.75 - $23.25/hr
... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...
$19 - $23.50/hr
Alert pharmacists appropriately for drug utilization reviews, calling and resolving third party rejections and rebilling claims, entering and processing refills and adding patients to Refills on Time ...
$19 - $23.50/hr
Alert pharmacists appropriately for drug utilization reviews, calling and resolving third party rejections and rebilling claims, entering and processing refills and adding patients to Refills on Time ...
Tacoma, WA · On-site
$32 - $36/hr
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Utilization Review or Discharge Planning experience * Inpatient hospital experience (MED-SURG is ...
Tacoma, WA · On-site
$32 - $36/hr
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Utilization Review or Discharge Planning experience * Inpatient hospital experience (MED-SURG is ...
... Pharmaceuticals, Banking & Financial Services, Transportation, Federal and State Government ... Conduct periodic reconciliation reviews of external interfaces with various field offices in order ...
... Pharmaceuticals, Banking & Financial Services, Transportation, Federal and State Government ... Conduct periodic reconciliation reviews of external interfaces with various field offices in order ...
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Utilization review experience * Case management experience highly preferred! Advantages of this ...
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Utilization review experience * Case management experience highly preferred! Advantages of this ...
Tacoma, WA · On-site
$78K/yr
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Perform telephonic review of prior authorization requests for appropriate care and setting ...
Tacoma, WA · On-site
$78K/yr
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Perform telephonic review of prior authorization requests for appropriate care and setting ...
Tacoma, WA · On-site
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... utilization management, prior authorization, concurrent review, and proficient with Excel ...
Tacoma, WA · On-site
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... utilization management, prior authorization, concurrent review, and proficient with Excel ...
Seattle, WA · On-site
$67 - $80/hr
... pricing and generic utilization, controlling pharmacy inventory, and providing/implementing ... Perform all functions of a staff pharmacist and act as a role model for the pharmacy team ...
Seattle, WA · On-site
$67 - $80/hr
... pricing and generic utilization, controlling pharmacy inventory, and providing/implementing ... Perform all functions of a staff pharmacist and act as a role model for the pharmacy team ...
Seattle, WA · On-site
Direct impact on veteran patient outcomes through non-pharmaceutical treatment options * High ... Increase Therapy Utilization & Revenue Growth * Drive measurable increases in therapy utilization ...
Seattle, WA · On-site
Direct impact on veteran patient outcomes through non-pharmaceutical treatment options * High ... Increase Therapy Utilization & Revenue Growth * Drive measurable increases in therapy utilization ...
Seattle, WA · On-site
... Pharmaceuticals, Banking & Financial Services, Transportation, Federal and State Government ... Tracks bridge utilization, maintains records of conference successes and issues as well monitoring ...
Seattle, WA · On-site
... Pharmaceuticals, Banking & Financial Services, Transportation, Federal and State Government ... Tracks bridge utilization, maintains records of conference successes and issues as well monitoring ...
Home, WA · Remote
$143K - $243K/yr
This includes clinical and utilization management, mac operations, analysis, financial management ... Supervises staff including Clinical Services Managers, Clinical Pharmacists, pharmacy technicians ...
Home, WA · Remote
$143K - $243K/yr
This includes clinical and utilization management, mac operations, analysis, financial management ... Supervises staff including Clinical Services Managers, Clinical Pharmacists, pharmacy technicians ...
Home, WA · Remote
$143K - $243K/yr
This includes clinical and utilization management, mac operations, analysis, financial management ... Supervises staff including Clinical Services Managers, Clinical Pharmacists, pharmacy technicians ...
Home, WA · Remote
$143K - $243K/yr
This includes clinical and utilization management, mac operations, analysis, financial management ... Supervises staff including Clinical Services Managers, Clinical Pharmacists, pharmacy technicians ...
... utilization of IDD diagnostic testing solution. This role owns the transition from customer ... Participate in ongoing training, field intelligence sharing, and performance reviews related to ...
... utilization of IDD diagnostic testing solution. This role owns the transition from customer ... Participate in ongoing training, field intelligence sharing, and performance reviews related to ...
$21.36 - $28.27
5% of jobs
$28.27 - $35.18
7% of jobs
$35.18 - $42.08
1% of jobs
$42.08 - $48.99
0% of jobs
$55.18 is the 25th percentile. Wages below this are outliers.
$48.99 - $55.90
13% of jobs
$55.90 - $62.80
11% of jobs
The median wage is $67.88 / hr.
$62.80 - $69.71
18% of jobs
$76.04 is the 75th percentile. Wages above this are outliers.
$69.71 - $76.62
22% of jobs
$76.62 - $83.53
13% of jobs
$83.53 - $90.43
7% of jobs
$90.43 - $97.34
3% of jobs
$21
$65
$97
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Full-time
Medical, Dental, Vision
Re-posted 16 hours ago
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Daily Responsibilities:
Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings
Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, or onsite to coordinate member care
Conduct discharge planning
Educate providers on utilization and medical management processes
Provide clinical knowledge and act as a clinical resource to non-clinical team staff
Enter and maintain pertinent clinical information in various medical management systems
Requirements:
RN license & associate's degree in Nursing
Must have discharge planning experience
Must have inpatient hospital experience (MED-SURG is ideal) - at least about 2 years
Computer skills! Must be comfortable & able to learn computer systems
Preferably have:
Interqual or Milliman experience
Utilization review experience
Case Management experience
Hours for this Position:
Flexible - roughly 8:00-5:00 or 8:30 to 5:00
Advantages of this Opportunity:
Competitive salary, negotiable based on relevant experience
Benefits offered, Medical, Dental, and Vision
Fun and positive work environment
Want More Information?
If you are interested in applying to this position, please contact Ashley Greene @ 407-478-0332 ext 169 or email and click the Green "I'm Interested" Button to email your resume.
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Recruiting and staffing services
201 - 500 Employees
Maitland, FL, US
2003