Utilization Review Nurse

Seattle, OR - USA

Monthly Salary: Not Disclosed

Posted on: 14 hours ago

Vacancies: 1 Vacancy

Job Summary

Job Description

UW Medical Centerhas an outstanding opportunity for anexperienced Utilization Review Nurseto join our team.

WORK SCHEDULE

Fully remote / work from home
Must be available to work day shifts during Pacific Standard Time
Sat Sun and one day during the week (8 hour shifts)

POSITION HIGHLIGHTS

Ensures the delivery of optimal care for our patients while promoting fiscal responsibility
Maintains efficient cost effective care management processes by determining the medical necessity and financial liability for all hospitalized patients
Plays a key role ensuring compliance with regulatory requirements policies and procedures

PRIMARY JOB RESPONSIBILITIES

Identify clinical indications for admission
Track hospital events and course in order to justify patient admission and continued stay for payer reimbursement
Communicate with third party payers regarding patient clinical progress
Assess and communicate potential reasons for payer denials and attempts to resolve the denial with the team at the time of identification
Participate in activities of identifying high risk vulnerabilities to the organization
Use critical thought processes and decision making in monitoring the continuum of care
Support work at both UW Medical Center Northwest and UW Medical Center - Montlake

REQUIREMENTS

3 years of work experience in utilization management
5 years of nursing work experience in an acute care med-surg setting
Bachelors Degree in Nursing or equivalent education and training
Active licensure to practice as a Registered Nurse in Washington State by start date
Knowledge of medical screening criteria
Computer skills to appropriately navigate electronic charting and referral systems
Case Management certification and previous experience with Xsolis software and MCG criteria preferred but not required

ABOUT UW MEDICINE WHERE YOUR IMPACT GOES FURTHER

UW Medicine is Washingtons only health system that includes a top-rated medical school and an internationally recognized research center. UW Medicines mission is to improve the health of the publicby advancing medical knowledge providing outstanding primary and specialty care to the people of the region and preparing tomorrows physicians scientists and other health professionals.

All across UW Medicine our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful welcoming environment where every patient family student and colleague is valued and honored. Nearly 29000 healthcare professionals researchers and educators work in the UW Medicine family of organizations that includes: Harborview Medical Center UW Medical Center - Montlake UW Medical Center - Northwest Valley Medical Center UW Medicine Primary Care UW Physicians UW School of Medicine and Airlift Northwest.

Become part of our team. Join our mission to make life healthier for everyone in our community.

Compensation Benefits and Position Details

Pay Range Minimum:

$108000.00 annual

Pay Range Maximum:

$150000.00 annual

Other Compensation:

Benefits:

For information about benefits for this position visit Shift (United States of America)

Temporary or Regular

This is a regular position

FTE (Full-Time Equivalent):

60.00%

Union/Bargaining Unit:

Not Applicable

About the UW

Working at the University of Washington provides a unique opportunity to change lives on our campuses in our state and around the world.

UW employees bring their boundless energy creative problem-solving skills and dedication to building stronger minds and a healthier return they enjoy outstanding benefits opportunities for professional growth and the chance to work in an environment known for its diversity intellectual excitement artistic pursuits and natural beauty.

Our Commitment

The University of Washington is committed to fostering an inclusive respectful and welcoming community for all. As an equal opportunity employer the University considers applicants for employment without regard to race color creed religion national origin citizenship sex pregnancy age marital status sexual orientation gender identity or expression genetic information disability or veteran status consistent with UW Executive Order No. 81.

To request disability accommodation in the application process contact the Disability Services Office at or .

Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.

Required Experience:

Job DescriptionUW Medical Centerhas an outstanding opportunity for anexperienced Utilization Review Nurseto join our team.WORK SCHEDULEFully remote / work from homeMust be available to work day shifts during Pacific Standard TimeSat Sun and one day during the week (8 hour shifts)POSITION HIGHLIGHTSE...