What are the responsibilities and job description for the Supv Utilization Review (Case Management) position at Asante?
Additional Position Details: FTE: 1.000000 | Full Time | Primarily Mon - Fri / 8AM - 5PM
PLEASE NOTE: This position may be remote. Candidates will be required to have reliable broadband internet and personal cell phone service. Remote work may include working day-to-day operations during Pacific Standard business hours or online training.
Position Summary
The Supervisor of Utilization Review is responsible for overseeing the daily operations of the utilization review team, ensuring compliance with payer guidelines, optimizing resource utilization, and facilitating appropriate patient care decisions. This role provides leadership, training, and guidance to UR staff while collaborating with clinical teams, revenue cycle, and payer representatives to minimize denials and improve reimbursement outcomes.
Position Qualifications
Experience
- A minimum of 2 years of demonstrated leadership in utilization review/clinical documentation integrity within a health care environment, with emphasis on community health resources and program development is required
- An additional 2 years of nursing experience in clinical practice areas such as acute care hospital, physician clinics, quality, case management, performance improvement, informatics is required
Education
- Bachelor's degree in nursing, or equivalent education and experience is preferred
Required Certification/Licensure
- RN: Registered Nurse (RN) by the Oregon State Board of Nursing or Allied Health Provider
Preferred Certifications/Licensures
- CCM: Certified Case Manager (CCM) or
- ACM: Accredited Case Manager (ACM)
- CCS: Certified Coding Specialist (AHIMA)
- CPC: Certified Professional Coder (AAPC)
- CCS-P: Certified Coding Specialist - Physician Based (AHIMA)
- CRC: Certified Risk Adjustment Coder (AAPC)
Total Rewards Package
- Earn a competitive and progressive salary
- Benefit from health plans that are focused on health and wellness including medical, dental, vision and wellness beginning within 30 days of hire
- Plan for your future with a retirement package that includes up to 6% employer contribution
- Experience a healthy work-life balance with our generous earned time off (ETO)
- Continue to enhance your education through our tuition reimbursement and tuition repayment plans
At Asante, we are guided by our values below. Explore Asante more by visiting www.asante.org/careers
Excellence - Respect - Honesty - Service - Teamwork
Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.
