Top Healthcare Services Jobs in Seattle, WA

Provide clinical oversight for utilization management and care transitions, perform daily UM reviews and peer-to-peer discussions, liaise with network and community providers, support care coordination and analytics needs, participate in medical advisory activities, and provide intermittent weekend/evening coverage.

Provide utilization management oversight for post-acute care transitions, conduct daily UM reviews and peer-to-peer discussions, liaise with network providers, support care coordination, contribute to strategy and analytics needs, participate in medical advisory activities, and provide intermittent weekend/evening coverage.

Coordinate post-acute care transitions by performing SNF assessments, managing concurrent reviews and authorizations, facilitating discharge planning with interdisciplinary teams, engaging patients/families, documenting accurately, and monitoring outcomes to support timely, safe discharges.

Provide physician oversight for utilization management and pre-service coverage determinations, document clinical reviews, engage providers in peer-to-peer discussions, collaborate with multidisciplinary teams, and support quality, cost-effective care delivery for members.

Manages day-to-day clinic operations for behavioral health and psychiatry, supervising staff, ensuring patient flow and quality, monitoring performance and budgets, resolving complaints, leading quality improvement, and coordinating coverage across multiple clinics.

Provide physician oversight for utilization management and pre-service coverage determinations in orthopedic (total joints or spine). Review cases, document findings, engage in peer-to-peer discussions, participate in call rotation, interpret benefit language and policies, and collaborate with internal teams and providers to ensure appropriate, cost-effective care.

Provide clinical oversight for utilization management and care transitions, perform daily authorization and denial reviews, conduct peer-to-peer reviews, communicate with network and non-network providers, develop action plans with Client Services and Analytics, advise on cost management and network strategy, participate on the Medical Advisory Board, and provide intermittent evening and weekend coverage.

Provide clinical leadership to improve evidence-based care, quality, utilization management, and member outcomes across national networks. Support reviews, appeals, clinical coverage, and data-driven initiatives in a remote, production-driven role.