Lead RN, Care Management & Utilization — Hybrid

GenZJobs; Bellevue (WA); Hybrid; USD 85,000 - 135,000; Full time

Job summary

Providence PacMed is seeking a Supervisor Care Management RN to supervise case management and utilization management, coordinating services to move patients through the continuum of care and review referrals for timeliness.

The role ensures medical necessity review and adherence to policy guidelines, while handling staff schedules and department operations under the guidance of the Director of Operations and Medical Director(s).

Qualifications

• Washington RN license required.
• Minimum of 5 years clinical experience.

Responsibilities

• Supervise case management and utilization management functions to ensure cost-effective resource use.
• Coordinate services to move patients through the continuum of care and review referrals for timeliness.
• Ensure compliance with TRICARE policy guidelines and department policies.
• Schedule staff and oversee department operations with Director and Medical Director collaboration.

Job description

Providence PacMed is seeking a Supervisor Care Management RN to supervise case management and utilization management, coordinating services to move patients through the continuum of care and review referrals for timeliness.

The role ensures medical necessity review and adherence to policy guidelines, while handling staff schedules and department operations under the guidance of the Director of Operations and Medical Director(s).