Clinical Utilization Review Nurse

1 week ago


Olympia, Washington, United States Providence Health & Service Full time

**Job Summary**

We are seeking a skilled Utilization Review Nurse to join our team at Providence St. Peter Hospital in Olympia, WA. As a key member of our Revenue Cycle department, you will be responsible for performing comprehensive admission, concurrent, and retrospective utilization reviews.

The ideal candidate will have a strong clinical background in nursing and excellent communication skills. You will work closely with multiple departments and staff members to ensure that patients receive the most appropriate care while meeting regulatory and reimbursement requirements.

**Key Responsibilities:**

  • Perform comprehensive admission, concurrent, and retrospective utilization reviews.
  • Analyze medical records and determine patient status based on regulatory and reimbursement requirements.
  • Develop and maintain effective processes for determining patient admission status.
  • Collaborate with healthcare providers and other stakeholders to ensure timely and accurate billing and payment.

**Requirements:**

  • Washington Registered Nurse License (R.N.).
  • 3+ years of experience in nursing, preferably in utilization review or related field.

**Benefits:**

As a valued member of our team, you can expect a competitive salary range of $55,000 - $115,000 per year, depending on experience. Our comprehensive benefits package includes health, dental, and vision insurance, 401(k) retirement plan, paid time off, and opportunities for professional growth and development.



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