Washington State Licensed UM Nurse

Job Summary

A company is looking for a Utilization Management Specialist Nurse.

Key Responsibilities

• Conduct concurrent utilization management activities and facilitate compliance with Utilization Review (UR) processes
• Serve as a resource for clinical and support staff, providing guidance on complex cases and daily assignments
• Collaborate with healthcare staff and management to ensure timely and accurate patient reviews

Required Qualifications

• Bachelor's degree in Nursing or equivalent experience; advanced degree preferred
• Current Registered Nurse license in Washington State or Multistate License endorsement
• Five years of clinical experience required; experience in utilization management or the insurance industry preferred
• Specialized knowledge and judgment in healthcare policies and procedures
• Ability to work independently and collaboratively within a healthcare team