Utilization Review & Care Coordination Specialist

Cascade Medical Center; Leavenworth (WA); On-site; USD 65,000 - 85,000; Full time

Job summary

Cascade Medical Center in Leavenworth, WA is seeking a full‑time Utilization Review Coordinator to lead day‑to‑day utilization review activities across inpatient, observation, ED, and outpatient services, including Endoscopy and infusion treatments.

The role applies medical necessity criteria, supports accurate patient-status determination, coordinates payer authorization, and monitors length of stay and denials while promoting complete clinical documentation.

Responsibilities

• Lead day-to-day utilization review activities for inpatient, observation, Swing Bed, Emergency Department, and outpatient programs, including Endoscopy (ENDO) and infusion treatments.
• Apply approved medical-necessity criteria, support accurate patient-status determination, coordinate payer authorization, monitor length of stay and denials, and promote complete clinical documentation.
• Coordinate with providers, nursing, Case Management, Clinical Social Work, registration, coding, billing, compliance, and Quality to support regulatory compliance, appropriate resource use, and accurate reimbursement.

Job description

Cascade Medical Center in Leavenworth, WA is seeking a full‑time Utilization Review Coordinator to lead day‑to‑day utilization review activities across inpatient, observation, ED, and outpatient services, including Endoscopy and infusion treatments.

The role applies medical necessity criteria, supports accurate patient-status determination, coordinates payer authorization, and monitors length of stay and denials while promoting complete clinical documentation.