Supervisor of Utilization Review

Supervisor of Utilization Review

Additional Position Details: FTE: 1.000000 | Full Time | Primarily Mon - Fri / 8AM - 5PM

Starting Wage for this exempt position: $107,036.80-$147,180.80, depending on experience

Please note: This is a remote position. Candidates will be required to have reliable broadband internet and personal cell phone service. Remote work may include online training and working during Pacific Standard business hours.

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
• PLUS, an additional 2 years of nursing experience in clinical practice areas such as acute care hospitals, physician clinics, quality, case management, performance improvement, and informatics is required

Education

• A bachelor's degree in nursing, or equivalent education and experience, is preferred

Required Certifications/Licensures

• RN: Registered Nurse Licensed by the Oregon State Board of Nursing

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

We offer a comprehensive Total Rewards package designed to support your well-being and professional growth, including:

• Competitive Pay: Hourly and salaried positions earn market-based compensation.
• Health & Wellness: Medical, dental, and vision coverage for part-time and above employees and their eligible dependents beginning within 30 days of hire.
• Retirement Savings: Employer-sponsored retirement plan with company contribution and match.
• Paid Time Off: Generous ETO for part-time and above employees.
• Professional Development: Continue to enhance your education through our tuition reimbursement and tuition repayment program
• Additional Benefits: Life insurance, disability coverage, and employee assistance programs.

At Asante, we are guided by our values:

Excellence - Respect - Honesty - Service - Teamwork

Asante is proud to be an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and to employing and advancing qualified individuals of all backgrounds, including women, minorities, individuals with disabilities, and protected veterans.