Utilization Management Specialist Nurse - Remote

Overview

The Utilization Management (UM) Specialist Nurse is responsible for overseeing utilization management activities for a licensed facility, ensuring compliance with regulations and facilitating optimal patient care.

In Short

• Responsible for concurrent utilization management activities.
• Acts as a liaison between patients, healthcare teams, and payers.
• Facilitates Utilization Review compliance.
• Oversees admission and continued stay reviews.
• Assists with complex case troubleshooting.
• Participates in a collaborative team approach.
• Requires specialized knowledge and judgment.
• Ensures timely and accurate reviews of patient cases.
• Works independently and collaboratively with healthcare staff.
• Contributes to the health and well-being of the community.

Requirements

• Bachelor's degree in Nursing required.
• Current Registered Nurse license in Washington State or Multistate License endorsement.
• Five years of clinical experience required.
• Utilization management and/or insurance experience preferred.
• Advanced Degree in Nursing preferred.
• Strong organizational and interpretive skills needed.
• Ability to work collaboratively and independently.
• Commitment to the core values of the organization.

Benefits

• Comprehensive benefits package offered.
• Competitive salary range.
• Medical and dental benefits provided.
• Retirement benefits included.
• Paid time off offered.
• Employee-centric workplace culture.
• Opportunities for growth and development.
• Recognition as one of America’s Best Employers by State.
• Access to leading research and innovation in healthcare.
• Work-life balance in the beautiful Pacific Northwest.