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Utilization Management NICU Nurse Reviewer

Community Health Plan of Washington Portland, OR
  • Posted: over a month ago
  • $29 to $37 Hourly
  • Full-Time
  • Benefits: Vision, Medical, Life Insurance, 401k, Dental

Community Health Plan of Washington (CHPW) has an opportunity for a Remote Utilization Management NICU Nurse Reviewer.

This role’s primary responsibility is to perform assessment and utilization review for patient medical requests using utilization review criteria, technologies and tools. This position is remote eligible (work from home) if you reside in Washington, Oregon, Idaho or Nevada.

This is a unique opportunity to join a dedicated team. At Community Health Plan of Washington, we believe that each of us shares a responsibility in helping others.

We are looking for:

· Bachelor’s degree in a relevant field, or an equivalent combination of education and highly relevant experience required.
· Current, unrestricted license as an LPN or RN required.
· Previous experience in Managed Care, Utilization Management required.
· NICU experience required.
· Two (2) years’ experience with Medicare, Medicaid and NCQA preferred.

We offer:

· Full medical, dental and vision benefits
· Community Service Hours
· Paid Time Off and Holiday Pay
· Tuition Reimbursement
· Transportation perks as a portion of our comprehensive and competitive benefits program
· Convenient downtown Seattle location near Pike Place Market

Interested? Learn more at chpw.org/careers

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Community Health Plan of Washington

For 25 years and counting, we've provided access to quality Medicaid coverage to Washington residents in their own communities. We expanded to cover Medicare patients in 2009 and entered the health care marketplace in 2013. All of our coverage is geared toward a model of care that treats the whole person and fosters trust, compassion, respect, and equality. We were founded in 1992 by Washington's community health centers. The CHC's wanted to form an insurance plan that would help coordinate care and advocate for people who were not being served by traditional insurance companies. We became the first not-for-profit managed care plan in the state, and today we are still the only not-for-profit to provide managed care to Apple Health members. Our mission is to deliver accessible managed care services that meet the needs and improve the health of our communities, and make managed care participation beneficial for community-responsive providers. We work for patients, and we work to help providers better serve those patients. Visit our career website at www.chpw.org/about-us/careers to learn more about our current opportunities.

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