Community Health Plan of Washington

Utilization Management Clinician I - RN or LPN


PayCompetitive
LocationSeattle/Washington
Employment typeFull-Time

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  • Job Description

      Req#: UTILI002341
      Employer Industry: Healthcare Services

      Why Consider this Job Opportunity:
      - Salary up to $CompetitivePay
      - Opportunity for career advancement and growth within the organization
      - Supportive and collaborative work environment
      - Chance to make a positive impact on reducing health disparities
      - Eligibility for remote work within specified states
      - Comprehensive benefits package including medical, dental, vision, and retirement options

      What to Expect (Job Responsibilities):
      - Conduct review of hospital notification or prior authorization care requests
      - Collaborate with facilities for discharge planning
      - Provide coordination support to members transitioning between care settings
      - Identify and recommend high-quality care options
      - Communicate effectively with medical directors and healthcare providers

      What is Required (Qualifications):
      - Bachelor's degree in a relevant field or equivalent experience
      - Current, unrestricted license as an RN, LPN, LMHC, LICSW, or LMFT
      - Minimum of two years clinical experience in healthcare settings
      - Previous experience in Utilization Management and Managed Care
      - Knowledge of clinical guidelines and health plan policies

      How to Stand Out (Preferred Qualifications):
      - Familiarity with criteria sets such as MCG, InterQual, ASAM, and LOCUS
      - Experience with care management workflow systems
      - Proficiency in Microsoft Office products

      #HealthcareServices #UtilizationManagement #CareerDevelopment #RemoteWork #InclusiveWorkEnvironment

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      Talentify is not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

      Community Health Plan of Washington puts you at the center of your care, so when your needs change, we change too. That includes expanding our virtual care services, making personal phone calls to check on you, and providing home delivery of your presc...