Clinical Navigator: Senior Utilization Review Nurse

Kaiser Permanente; Renton (WA); On-site; USD 110,000 - 140,000; Full time

Job summary

Kaiser Permanente in Renton, WA is seeking a Senior Utilization Review Nurse II for a Clinical Navigator role focused on population health, health equity, and care delivery optimization. The position collaborates with clinicians, operations, and quality teams to close care gaps and improve outcomes.

The role requires expert clinical knowledge of guidelines, policies, and criteria to advise on level of care, discharge planning, and referrals, while leading cross-disciplinary efforts for

Qualifications

• BSN and 7+ years in direct patient care or utilization management.
• At least 3 years in a leadership role.
• RN license (Washington) required at hire or Compact license: RN required at hire.

Responsibilities

• Promotes learning by guiding cross-functional stakeholders and mentors junior staff.
• Leads business projects applying deep subject-area expertise and problem-solving.
• Drives physician and staff communications on medical necessity and denials across the care continuum.
• Develops education programs for staff and physicians on utilization management.
• Conducts data analyses and reports to identify utilization patterns and opportunities for improvement.
• Oversees utilization reviews by following policies to evaluate necessity and efficiency of services.

Skills

Leadership

Communication

Interpersonal skills

Education

Bachelor's Degree in Nursing

Job description

Kaiser Permanente in Renton, WA is seeking a Senior Utilization Review Nurse II for a Clinical Navigator role focused on population health, health equity, and care delivery optimization. The position collaborates with clinicians, operations, and quality teams to close care gaps and improve outcomes.

The role requires expert clinical knowledge of guidelines, policies, and criteria to advise on level of care, discharge planning, and referrals, while leading cross-disciplinary efforts for