RN - Utilization Review

Providence • Everett, WA

1d • Onsite

About The Position

Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Regional Medical Center Everett and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Regional Medical Center Everett received the HealthGrades Distinguished Hospital Award for Clinical Excellence four years in a row.

Requirements

• Bachelor's Degree Nursing (BSN). Must obtain a Bachelor’s degree in Nursing or higher within (5) years of hire.
• Any previously agreed upon effective date for obtaining a Bachelor’s degree in nursing between individual and facility will remain in effect.
• Any collective bargaining contract with specific time frames for obtaining a Bachelor’s degree in nursing will supersede the above point and will remain in effect.
• Exceptions will be considered on a case-by-case basis at each facility by the most senior administrative nursing leader in consultation with the Human Resources leader.
• Upon hire: Washington Registered Nurse License
• Experience as an RN in an acute care setting within the last 5 years, OR recent Utilization Management experience

Nice To Haves

• Utilization review or case management experience
• Experience with Interqual or Milliman Criteria Care Management, medical insurance or discharge planning experience
• 1 year of Experience with Neonatal Intensive Care (NICU) clientele

Responsibilities

• Oversee utilization management and review of patients care delivery while in the hospital
• Provide clinical reviews and denial appeals where appropriate either during admission or post discharge.

Benefits

• Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees