Utilization Review (RN) - Part Time (28 hours/week)

Location: 603 S Chestnut St, Ellensburg, WA 98926, USA

Salary: USD 44.70–79.60 per hour, based on applicable experience. Shift differentials apply for evenings, nights, and weekends.

Company

hirify.global is an integrated healthcare delivery system providing emergency, inpatient, outpatient, clinic, home health, hospice, rehabilitation, surgical, pediatric, women's health, and urgent care services.

What you will do

• Evaluate the medical necessity, appropriateness, and efficiency of healthcare services using MCG criteria.
• Coordinate timely insurance pre-authorizations and confirm medical necessity in line with payer requirements.
• Support safe care transitions and help prevent avoidable denials.
• Monitor length of stay, avoidable days, admission order status, and utilization-related financial risks.
• Investigate denials and revenue loss with clinical teams, case management, revenue cycle leadership, finance teams, and payers.
• Report utilization trends and findings to the Utilization Review Committee to support compliance and continuous improvement.

Requirements

• Graduate of an accredited nursing program with a current Washington State RN license or Multistate License with Washington endorsement.
• At least 3 years of clinical nursing experience in acute care.
• Experience with evidence-based care guidelines such as InterQual or MCG.
• Familiarity with CMS Conditions of Participation, commercial health insurance, and managed care billing requirements.

Nice to have

• Bachelor of Science in Nursing.
• Experience with Cerner EHR.
• Knowledge of MCG care guidelines.
• Hospital case management experience.

Culture & Benefits

• Part-time schedule of 0.7 FTE, or 28 hours per week.
• Benefits-eligible position with medical, dental, and vision insurance options.
• Employee wellness programs and continuing education opportunities.
• Certification pay and pension eligibility after one year of part-time employment.
• WSNA union-covered position.