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Job Description

UW Medical Center - Montlake** has an outstanding opportunity for **a Utilization Management Nurse.

POSITION HIGHLIGHTS

The goal of the **Utilization Management (UM) Nurse** is to ensure delivery of optimal care for the patient while promoting fiscal responsibility and establishes and maintains an efficient, cost effective care management process by determining the medical necessity and financial liability for patients all hospitalized patients. The UM Nurse communicates this information with the interdisciplinary team to ensure compliance with regulatory requirements, policies and procedures, and quality patient care for the duration of the hospitalization. The UM Nurse is responsible for maintaining the knowledge and skill set related to utilization review, care coordination, and performance improvement, while working in a manner which supports the mission and vision of Care Management at University of Washington Medical Center, and ensures that daily operations, procedures and standards of care are maintained in accordance with hospital and JACHO guidelines.

WORK SCHEDULE

+ 100% FTE

+ Mondays-Friday, Days

+ Remote

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

REQUIREMENTS

+ Bachelor's Degree in Nursing or equivalent education and training

+ Five years nursing experience in an acute care oncology setting

+ Three years previous experience in utilization management

+ Case Management experience

+ Knowledge of medical screening criteria required

+ Able to demonstrate and communicate the knowledge and skills necessary to provide care appropriate to the age of the patients served on the assigned unit(s)/department

+ Ability to handle a fluctuating workload

+ Computer skills consistent with electronic charting and referral system

+ Current license to practice as a registered nurse in the State of Washington

ABOUT UW MEDICAL CENTER-MONTLAKE

UW Medical Center is an acute care academic medical center 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 seven specialties, UW Medical Center prides itself on compassionate patient care as well as its pioneering medical advances.

The UW Medical Center-Montlake campus is located on the edge of the beautiful UW campus which includes many amenities available to our staff as well as very convenient public transit options including the Sound Transit’s light rail station across the street.

Excellence. Exploration. Education. (https://www.uwmedicine.org/about/career-opportunities/uw-medical-center-montlake)

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 (https://www.uwmedicine.org/jobs) . Join our mission to make life healthier for everyone in our community.

Compensation, Benefits and Position Details

Pay Range Minimum:

$108,876.00 annual

Pay Range Maximum:

$150,000.00 annual

Other Compensation:

-

Benefits:

For information about benefits for this position, visit https://www.washington.edu/jobs/benefits-for-uw-staff/

Shift:

First Shift (United States of America)

Temporary or Regular?

This is a regular position

FTE (Full-Time Equivalent):

100.00%

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 world. In 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 proud to be an affirmative action and equal opportunity employer (https://hr.uw.edu/eoaa/) . All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, age, protected veteran or disabled status, or genetic information.

To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or [email protected] .

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 (https://app.leg.wa.gov/RCW/default.aspx?cite=28B.112.080) .

University of Washington is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disabled status, or genetic information.