Care Management RN | Utilization Review & Coordination

Jimmy Jazz; Olympia (WA); On-site; USD 85,000 - 120,000; Full time

Job summary

Jimmy Jazz in Olympia, WA is seeking a Registered Nurse focused on Utilization Review and Care Management. You will perform pre-cert, concurrent, and retrospective reviews using InterQual, NCD, and LCD criteria to ensure timely and appropriate care while coordinating with the health care team.

The role emphasizes documentation, compliance with HIPAA and plan requirements, and collaboration with interdisciplinary teams to support high-quality patient outcomes and efficient resource use.

Qualifications

• Three (3) years of full proficiency clinical experience.
• Minimum 1 year of experience in UM/UR.
• Knowledge of hospital/patient care facilities and current practices.
• Knowledge of care management and/or transitional care management services.

Responsibilities

• Exceed physician, provider and member expectations with professional service.
• Attend collaborative meetings with healthcare team members.
• Coordinate services to support appropriate care needs and promote best outcomes.
• Document all interventions and telephone encounters per standards.
• Provide comprehensive training for new employees.

Skills

Communication skills

Team player

Problem solving

Organizational skills

MS Office

Electronic Health Records

Interpersonal skills

Education

Bachelor’s degree in Nursing

CCM or HUMC certification

Tools

InterQual criteria

Medicare knowledge

Job description

Jimmy Jazz in Olympia, WA is seeking a Registered Nurse focused on Utilization Review and Care Management. You will perform pre-cert, concurrent, and retrospective reviews using InterQual, NCD, and LCD criteria to ensure timely and appropriate care while coordinating with the health care team.

The role emphasizes documentation, compliance with HIPAA and plan requirements, and collaboration with interdisciplinary teams to support high-quality patient outcomes and efficient resource use.