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Utilization Review RN 7/28/2018

Qualis Health Seattle, WA

Seattle, WA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)


Job Description

Qualis Health assists clients to be responsible stewards of healthcare resources by avoiding overuse, misuse and underuse of health services. Our utilization management best practices assure that patients receive the right care, in the right setting, at the right time. We provide web-based utilization reviews and targeted review programs based on extensive data analysis. Our focus is on patient safety and cost containment, while also leveraging our deep experience and knowledge of evidence-based protocols to deliver appropriate and optimized care. In this role, you would:

* Participate in a multi-disciplinary team to improve the quality of healthcare for individuals and populations.

* Apply nationally-recognized clinical criteria and guidelines to determine the medical necessity of inpatient admissions, outpatient procedures, advanced imaging studies, and other healthcare services.

* Consult with physicians or refer cases to others, when indicated.

Required Skills

* A degree or diploma in nursing.

* Current, active, unrestricted RN licensure in Washington state.

Required Experience

* 4+ years of clinical experience (ICU/CCU, step-down, med/surg, E.D., orthopedics, internal medicine, or family practice preferred).

Qualis Health is an Equal Employment Opportunity Employer that embraces and practices diversity, reflecting the communities we serve. We encourage minorities,Protected Veterans, and individuals with disabilities to apply.
Thank you for your interest in working with us!