Be an early applicantLess than 25 applicants

Company

MultiCare Health System · 5 hours ago

Utilization Management Manager - Denial Appeals and Audit

Tacoma, WA

Full-time

Remote

Mid, Senior Level

$169K/yr - $234K/yr

5+ years exp

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Health CareInformation Technology

H1B Sponsor Likely

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Responsibilities

Manage the day-to-day operations of the Utilization Management Program system-wide to accomplish all established goals within the provisions of MHS policies and standards and federal, state and local regulations.

Work closely with Medical Advisors and Physician Leaders/Executives to resolve issues of medical necessity.

Ensure cost effective and quality patient care by managing appropriate utilization of resources.

Provide direction and guidance to staff, setting/monitoring productivity and quality standards.

Serve as the utilization management resource/expert.

Manage the denial/appeal process and consistently model teamwork and collaboration competencies.

Qualification

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BSNRegistered Nurse licenseUtilization management experienceSupervisory experienceSpecialty certificationDischarge planning experience

Required

BSN or bachelor's degree in health care related field required

Current license as a Registered Nurse license in Washington State or Multistate License endorsement (MLS)

Five (5) years of experience in nursing roles including duties aligned with utilization management and discharge planning

Three (3) years of experience in a supervisory or lead capacity

Preferred

Specialty certification preferred

Benefits

Medical

Dental

Retirement benefits

Paid time off

Company

MultiCare Health System

Glassdoor

3.5

Multicare Health System operates as a not-for-profit health care organization.

Founded in 1882

Tacoma, Washington, USA

10,001+ employees

http://www.multicare.org

H1B Sponsorship

MultiCare Health System has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (41)

2022 (9)

2021 (10)

2020 (7)