Utilization Review Lead – Inpatient, ED & Ambulatory

Cascade Medical; Leavenworth (WA); On-site; USD 65,000 - 90,000; Full time

Job summary

Cascade Medical in Leavenworth, WA seeks a full-time Utilization Review Coordinator to lead day-to-day review for inpatient, observation, Swing Bed, ED and outpatient programs such as Endoscopy and infusion.

The role applies approved medical-necessity criteria, supports accurate patient-status determination, coordinates payer authorization, monitors length of stay and denials, and promotes complete clinical documentation; onsite, 40 hours weekly, with weekend shifts as needed.

Responsibilities

• Leads day-to-day utilization review activities for inpatient, observation, Swing Bed, Emergency Department and outpatient programs, including Endoscopy and infusion treatments.
• Applies approved medical-necessity criteria and supports accurate patient-status determination.
• Coordinates payer authorization, monitors length of stay and denials, and promotes complete clinical documentation.
• Collaborates with providers, nursing, Case Management, Clinical Social Work, registration, coding, billing, compliance, and Quality to support regulatory compliance and accurate reimbursement.

Job description

Cascade Medical in Leavenworth, WA seeks a full-time Utilization Review Coordinator to lead day-to-day review for inpatient, observation, Swing Bed, ED and outpatient programs such as Endoscopy and infusion.

The role applies approved medical-necessity criteria, supports accurate patient-status determination, coordinates payer authorization, monitors length of stay and denials, and promotes complete clinical documentation; onsite, 40 hours weekly, with weekend shifts as needed.