Utilization Review RN

DescriptionThis is a remote role. You MUST live in the state of Washington (WA) to be consideredCare Manager RNPer diem / On callDay shiftThe Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient processes for determining the appropriate admission status based on regulatory and reimbursement requirements of commercial and government payers. The UR nurse is responsible for performing admission, concurrent and retrospective UR related reviews and functions to ensure that appropriate data is tracked, evaluated and reported. This individual actively participates in process improvement initiatives, working with multiple departments and multi-disciplinary staff.Providence caregivers are not simply valued - they're invaluable. Join our team at Swedish Shared Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.Required Qualifications:Bachelor's Degree in Nursing degree (BSN) from an accredited school of nursing.Washington Registered Nurse License upon hire.3 years of Registered nursing experience in the clinical setting.Preferred Qualifications:ACM or CCM certification upon hire.1 year of Case management experience.Why Join Providence?Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission of improving the health and wellbeing of each patient we serve.Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.About ProvidenceAt Providence, our strength lies in Our Promise of

Created: 2025-09-12