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Waystar · 1 month ago

Clinical Product Consultant - Utilization Management

Atlanta, GA

Full-time

Hybrid

Senior Level, Lead/Staff

8+ years exp

Waystar is a company that simplifies healthcare payments and improves financials for providers. The Clinical Product Consultant for Utilization Management will provide clinical insights for product development, ensuring that AI technology meets client needs through data analysis and auditing, while also facilitating user adoption of best practices.

FinanceHealth CarePaymentsSoftware

Growth Opportunities

Responsibilities

Collaborate with the product and services teams to execute our strategic plan for AwareUM

Audit for product accuracy and effectiveness, communicating with product for change as identified

Assess effectiveness of AwareUM technology in creating efficient workflow for UM nurses

Deliver on go-forward product milestones balancing client requests with investment in new capabilities that deliver on the vision for the product

Collaborate with the UM growth team and support a smooth sales delivery process that results in achievement of targeted growth expectations

Collaborate with the CX team to create a seamless, integrated, and consistent user experience

Actively manage the client experience to deliver on implementation milestones, manage client support requests and expectations and monitor client successful use of the product

Qualification

Utilization ManagementClinical ExperienceNursing LicenseCare ManagementQuality ManagementReimbursement ModelsInterQual ProductsSoftware TrainingGoogle SuiteExcelPowerPointCommunication SkillsTeam Collaboration

Required

Bachelor of Science in Nursing (BSN) or equivalent (with RN licensure)

8+ years of clinical experience in acute care setting

2+ years of experience in utilization management

Knowledge and understanding of Utilization Management, Quality Management, Care Management, and/or Chronic Condition Management within hospital systems, post-acute providers, and/or payers

Demonstrates an understanding of evolving reimbursement models, including commercial payers, Medicaid, and Medicare

Demonstrates an understanding of CMS and payer regulations as it pertains to patient status and care management

Works effectively on a multidisciplinary team

Demonstrates flexible, positive, clear interpersonal and communication skills with ability to facilitate the exchange of information with internal and external clients

Ability to work remotely, effectively, and efficiently

Proven history of collaborative, team-focused approach

Excellent oral and written communication skills

Ability to travel 20-50% of the time, to domestic locations for client or business meets

Preferred

Experience leading a Utilization Management team in an acute care setting

Active and current Utilization and/or Case Management Certification

2-3 years' experience with MCG and/or InterQual products and services

Experience in the software training and education for health-care related products preferred

Knowledge of core software applications including google, excel, power point

Benefits

Competitive total rewards (base salary + bonus, if applicable)

Customizable benefits package (3 medical plans with Health Saving Account company match)

We offer generous paid time off for our non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. We also offer flexible time off for our exempt team members + 13 paid holidays

Paid parental leave (including maternity + paternity leave)

Education assistance opportunities and free LinkedIn Learning access

Free mental health and family planning programs, including adoption assistance and fertility support

401(K) program with company match

Pet insurance

Employee resource groups