Location: Tacoma, WA
Job Type: Direct Hire
Salary: $90,000.00 - $105,000.00
Degree: Bachelor;
Date: 3/8/2018
Job ID: 02544230
Job Description

Growing team needs a strong leader and mentor for their UM nurses.  Excellent communication with staff to enhance & facilitate daily department function is essential. GROWTH potential is excellent- rich benefit package!
•  Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives.
•  Promote compliance with federal and state regulations and contractual agreements.
•  Develop, implement and maintain compliance, policies and procedures regarding medical utilization management functions.
•  Develop, implement, and maintain utilization management programs to facilitate the use of appropriate medical resources and decrease the business unit's financial exposure.
•  Compile and review multiple reports on work function activities for statistical and financial tracking purposes to identify utilization trends and make recommendations to management.
•  Facilitate on-going communication between utilization management staff and contracted providers.
•  Develop staff skills and competencies through training and experience. Available to non-clinical staff as a resource for clinical questions.

- Bachelor’s degree in related field or equivalent experience. Bachelor’s degree in nursing preferred.
-3+ years utilization management and recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics and management experience.
- Thorough knowledge of utilization management and clinical nursing.

-Familiarity with Medicare and Medicaid managed care practices and policies, CHIP and SCHIP.
- Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
- RN license required
- Case Management Certification preferred.