Utilization Review Coordinator: Full Time

Our take on this role

About this role

Lead day-to-day utilization review for inpatient, observation, Swing Bed, emergency department, and outpatient programs, including endoscopy and infusion treatments. This position works onsite.

What could you bring from clinical work?

• Nurses: Reviewing clinical records to assess care needs could help you apply approved medical-necessity criteria and support accurate patient-status determination.
• Social workers: Your experience coordinating care and discharge plans may help you work with Case Management and Clinical Social Work to support appropriate resource use.

Full job description from Cascade Medical Center

Cascade Medical, in beautiful downtown Leavenworth in the foothills of the Cascade Mountains, is looking for a full time Utilization Review Coordinator.

Job Summary: The Utilization Review Coordinator leads day-to-day utilization review activities for inpatient, observation, Swing Bed, Emergency Department, and outpatient programs, including Endoscopy (ENDO) and infusion treatments. This 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. The coordinator works closely with providers, nursing, Case Management, Clinical Social Work, registration, coding, billing, compliance, and Quality to support regulatory compliance, appropriate resource use, and accurate reimbursement.

Work Schedule: Schedule is anticipated to be 40 hours per week Monday-Friday along with occasional weekend shifts. Exact scheduled hours to be determined with the director upon hire. This position will work onsite.

Please review the job description for full position details.

To Apply: Please complete an online application and upload a resume and cover letter of interest.

As a public entity, our wage range is set on a 30-step scale (Base-30 years of experience). Offer letters and wage determination will be written based on years of experience.

This is a safety sensitive position that will require a pre-employment drug screen, including testing for THC.