UW Medical Center - Northwest has an outstanding opportunity for an experienced Utilization Review Nurse to join our team.
WORK SCHEDULE
100% remote / work from home
Must be available to work day shifts during Pacific Standard Time
40 hours per week
Occasional weekend work required
POSITION HIGHLIGHTS
Ensures the delivery of optimal care for our Behavioral Health and med/surg 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
ABOUT THE CENTER FOR BEHAVIORAL HEALTH AND LEARNING
The new Center for Behavioral Health and Learning, opening on the UW Medical Center - Northwest campus in 2024, offers an unparalleled opportunity to transform mental health care and to improve mental health care training in our state. Located in North Seattle, the new facility will feature 75 longer-term adult psychiatry beds, 25 geriatric psychiatry beds, 50 medical/surgical beds focused on patients with psychiatric comorbidities, and a state-of-the-art neuromodulation program. It will also house an interdisciplinary training and workforce development program focused on preparing and supporting the next generation of behavioral health providers for Washington State. The six-story building will be a beautiful place to work with lots of windows, natural lighting and open-concept spaces and will offer amenities including a new kitchen and dining area for patients, staff and visitors.
Learn more about the Center for Behavioral Health and Learning here.
REQUIRED POSITION QUALIFICATIONS
3 years of work experience in utilization management
5 years of nursing work experience in an acute care med-surg setting
Bachelor's Degree in Nursing, or equivalent education and training
Active licensure to practice as a Registered Nurse in Washington State
Knowledge of medical screening criteria
Computer skills to appropriately navigate electronic charting and referral systems
ABOUT UW MEDICAL CENTER-NORTHWEST
UW Medical Center is an acute care hospital located in Seattle with two campuses: Montlake and Northwest. As the No. 1 hospital in Seattle and Washington State since 2012 (U.S. News & World Report) and nationally ranked in six specialties, UW Medical Center prides itself on compassionate patient care as well as its pioneering medical advances.
The UW Medical Center–Northwest campus offers emergency and inpatient and outpatient medical, surgical, and therapeutic care. It is located in north Seattle on a beautiful, easy-to-access 44-acre campus that includes the neighboring Northwest Outpatient Medical Center and Specialty Care Meridian Pavilion.
Teamwork. Community. Opportunity. Become part of our team. Join our mission to make life healthier for everyone in our community.
ABOUT UW MEDICINE – WHERE YOUR IMPACT GOES FURTHER
UW Medicine is Washington’s only health system that includes a top-rated medical school and an internationally recognized research center. UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s 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 29,000 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.