Case Management/Utilization Review Supervisor

At Snoqualmie Valley Health, we’re not just in the business of healthcare; we’re in the business of empowering our community to live boldly and live well. Our commitment to excellence and innovation calls for team members who will build trust, obsess over excellence, lead innovation, and deepen connections within our community. We are guided by our core values, and we’re looking for someone who can embody those principles as part of our dynamic and growing team.

Located in a trailblazing, adventure-loving town at the base of the Cascades, Snoqualmie Valley Health is an independent public hospital district serving a vibrant community that thrives on both adventure and connection. This is more than a job—it’s an opportunity to be part of something bigger.

$3,000 Sign on Bonus!

POSITION SUMMARY: The Patient Transition Services Supervisor is a registered nurse responsible for leading the coordination of patient transitions on the Medical Unit, ensuring quality, cost-effective care while maintaining compliance with payer and CMS regulations. This role oversees intake coordination, case management, utilization review, and social work. The Supervisor supports high-quality patient outcomes by monitoring referrals, discharge planning, insurance verification, and medical necessity reviews, all while championing collaborative, patient-centered care.

ESSENTIAL FUNCTIONS:

Build Trust: We exhibit integrity, transparency and compassion in every interaction.

• Supervise the intake process to ensure admissions meet criteria and regulatory guidelines.

• Advocate for quality care, patient rights, and effective communication across teams.

• Chart review and educate to ensure accurate and transparent documentation for all patient-related care.

Obsess Over Excellence: We have high standards and seek continuous improvement.

• Conduct ongoing reviews of clinical data and medical necessity.

• Ensure timely and thorough utilization review and payer communications.

• Monitor and support compliance with payer contracts and CMS guidelines.

• Regularly review patient length of stay and discharge readiness to reduce avoidable days.

Lead Innovation: We lead with creativity, agility and think bold in our approach.

• Support active collaboration with rehabilitation teams, providers, and nursing staff to drive optimal treatment plans.

• Identify process improvements to streamline referrals, transitions, and discharge coordination.

• Utilize technology and clinical tools for real-time updates, data review, and efficiency gains.

Obsess Over Excellence: We have high standards and seek continuous improvement.

• Conduct ongoing reviews of clinical data and medical necessity.

• Ensure timely and thorough utilization review and payer communications.

• Monitor and support compliance with payer contracts and CMS guidelines.

• Regularly review patient length of stay and discharge readiness to reduce avoidable days.

Lead Innovation: We lead with creativity, agility and think bold in our approach.

• Support active collaboration with rehabilitation teams, providers, and nursing staff to drive optimal treatment plans.

• Identify process improvements to streamline referrals, transitions, and discharge coordination.

• Utilize technology and clinical tools for real-time updates, data review, and efficiency gains.

Deepen Connections: We build strong relationships with our patients, their families and partners in the communities we serve.

• Support coordination of discharge plans with multidisciplinary teams and community resources.

• Support patient transitions team through complex medical transition patient planning with empathy and clarity.

• Communicate frequently with Medical Unit Manager and attend organizational leadership meetings.

QUALIFICATIONS:

Required Education: Bachelor’s degree in Nursing (BSN)

Preferred Education: Case Management or Utilization Review certification

Required Licensure: Current RN license, State of Washington

Specialty Certification:

• Basic Life Support (BLS) – required within 60 days of hire

Required Experience:

• Minimum 2 years in Utilization Management and/or Case Management

Skills:

• Strong leadership and communication skills

• Proficiency with word processing and spreadsheet software

• Excellent time management and critical thinking abilities

• Ability to stay organized and lead in a fast-paced, multidisciplinary environment

WORK ENVIRONMENT:

• Office and clinical settings with potential exposure to patient care areas.
• Flexibility to work extended hours as needed.

PHYSICAL DEMANDS:

• Ability to work in a fast-paced environment and handle multiple priorities.
• May require occasional travel between facility locations.

OTHER DUTIES: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

BENEFITS: We believe in taking care of those who take care of our community. We’re proud to offer a comprehensive benefits package that puts your health and well-being first. With our flexible medical plan, you’ll have access to multiple in-network tiers, including top-quality care from Snoqualmie Valley Health, Eastside Health, and First Choice/First Health providers. The best part? Anyone covered under our plan can receive care at SVH at no cost! It's all about giving you the options and support you need to experience life’s great adventures.

• Medical
• Dental
• Vision
• Pharmacy
• Health Reimbursement Account (HRA)
• Life and AD&D
• Retirement Plan
• Employee Assistance Program (EAP)
• Flexible Spending Account (FSA)
• Travel Assistance & ID Theft Protection
• Pet Insurance
• Other Voluntary Benefits

Benefit Eligibility Requirements - Employees regularly scheduled at least 20 hours per week.

Employee Dependents - Your legal spouse or domestic partner; dependent children until age 26.

Waiting Period - 1st of the month following 30 days from your date of hire.

PLEASE NOTE:

• The Flu shot or documented and approved exemption (during Flu season) is a condition of employment.

• Snoqualmie Valley Hospital is a drug-free workplace. We require a drug screening as a part of our onboarding process.