Home › Companies › 8A60330E4601A7C93B62D516356235C3 › Utilization Management Specialist
Utilization Management Specialist
8A60330E4601A7C93B62D516356235C3 · Remote · Active · $23–$33 / hour · Paycom ATS
Job facts
| Field | Value |
|---|---|
| Company | 8A60330E4601A7C93B62D516356235C3 |
| Title | Utilization Management Specialist |
| Normalized title | - |
| Department / team | - |
| Location | United States |
| Work model | Remote / Remote |
| Employment type | - |
| Salary | $23–$33 / hour |
| Status | active |
| ATS provider | Paycom ATS |
| Posted / first seen | 2026-03-27 / 2026-05-31 |
| Changed / last seen | 2026-06-04 / 2026-06-06 |
Related slices
| Page | What it contains | Open |
|---|---|---|
| Company jobs | Active postings from 8A60330E4601A7C93B62D516356235C3. | Open |
| Company breakdowns | Role, location, ATS, and work model facets for this company. | Open |
| ATS provider jobs | Active postings observed through Paycom ATS. | Open |
| Provider filtered search | The same provider as a filtered job collection. | Open |
| Work model jobs | Active Remote postings. | Open |
| Lifecycle events | Open, update, close, and reopen events for this posting. | Open |
| Original posting | Canonical source or apply URL captured from the ATS. | Open |
Linked records
| Company | 8A60330E4601A7C93B62D516356235C3 |
| Source | 897897e3-8fd8-4dea-b31e-36ab265c047c |
| ATS provider | Paycom ATS |
Description
Description
Who You’ll Join
At Santiam Hospital & Clinics , we believe exceptional patient care starts with a supportive and inclusive work environment. We empower every team member by providing access to advanced medical technology and continuous professional development. Join our collaborative culture, where your contributions are valued and your growth is encouraged.
Come join our Utilization Management team as our new Utilization Management Specialist where you will play a critical role in ensuring patients receive the right care at the right time. Using clinical expertise and strong payer collaboration, this role drives timely authorizations, supports medical necessity decisions, and ensures compliance with CMS and payer guidelines. It’s an ideal opportunity for detail driven professionals who want to influence quality outcomes and support providers, while making a meaningful impact across the continuum of care.
Take the next step in your healthcare career—apply today and bring your expertise to Santiam Hospital & Clinics , recently honored as 2025’s Best Hospital in the Willamette Valley !
Position Schedule: Monday – Friday, 8:00 am – 12:00 pm Salary range: $22.50 - $33.04
What You’ll Do:
Performs clinical chart reviews for appropriate admissions, continued stays, and supportive services to promote quality care and full and accurate capture of revenue.
Ensure compliance with CMS, state, and payer-specific utilization review requirements
Submit and monitor payer notifications for admissions, continued stay, and changes in status
Follow authorizations from initial notification through approval and additional authorized days, including entering and monitoring approved bed days in UM navigator
Proactively engaged in obtaining auth approvals and continued follow-up as needed for approval/denials
Communicates with insurance companies regarding the medical necessity of admissions and provides clinical documentation and reviews as requested for purposes of ongoing authorization of hospital stays.
Communicate discharge information and clinical updates to payers as required daily.
Communicate with the attending physician or nursing staff, when needed, to address the appropriate level of care, and order changes.
Collaborate with CML and UM staff to deliver appropriate Medicare forms to patients when required (e.g., Code 44, Code W2, and Hospital Issued Notices of Non-Coverage).
Keeps Patient Registration and Patient Financial Services informed of any changes in admission status, working toward accurate capture of admission status prior to initial billing.
Continually assesses clinical services for appropriateness for continued stay.
Serves as a resource and actively provides education for physicians related to Medicare and third-party payor billing requirements, correct admission status, and documentation supporting medical necessity.
Participates in the Utilization Review Committee.
Assists UM RN Lead in medical necessity denial and appeals processes, ensuring prompt and accurate follow-up to ensure resolution and timely billing.
Documents actions taken in the patient financial record and clinical review in UM navigator.
Qualifications
What You’ll Need:
Knowledge of principles that relate to the position, including regulations and accreditation standards that pertain to Utilization management
Aptitude in verbal and written communication, including ability to communicate with persons in all age groups
Associate's degree or higher in Health Information management preferred
Possession of current applicable certification and registration preferred – RHIT
Possession of United States proof of citizenship or right to work in the United States
Possession of a driver license or analogous identification
Willingness to participate in Hospital orientation and educational in-service
Minimum of 2 years of experience in a similar hospital-related position with utilization experience preferred.
Must reside in Oregon.
Benefits for Eligible Positions:
Medical, Vision and Dental Insurance
PTO and holiday pay
Employee Referral Program
401(k) Retirement
Life Insurance
Long Term Disability
Employee Discounts
Bilingual Pay Differential for eligible positions
Public Service Loan Forgiveness for eligible positions
Tuition Assistance for eligible positions
Why Santiam Hospital?
At Santiam Hospital & Clinics, we pride ourselves on fostering a supportive and inclusive work environment where every team member is valued and empowered to make a difference. Our commitment to excellence in patient care is matched by our dedication to employee growth and well-being. As part of our team, you’ll have access to cutting-edge medical technology, ongoing professional development opportunities, and a collaborative culture that encourages innovation and teamwork. Join us at Santiam Hospital & Clinics, where your skills and compassion will be appreciated, and together, we can make a positive impact on the health and lives of our community.
With 12 clinics offering 8 specialties, you’ll be part of a diverse and dynamic healthcare community. We’re proud to have been named the 2025 Best Place to Have a Baby, Best Hospital as well as receiving accolades for our Surgery Center, Medical Facility and Women’s Clinic, reflecting our unwavering commitment to providing exceptional care for our patients.
Santiam Hospital & Clinics is a drug-free workplace in accordance with the Drug-Free Workplace Act of 1988 and an EEO Affirmative Action Race/Sex/Sexual Orientation/Gender Identity/National Origin/Veteran/Disability Employer.
Full job record
| Job ID | c1916fbaa22190f11a6a75b6d63e9f89e035e8d7 |
| Org ID | b6a98371-73be-4a26-959b-eb95323dedda |
| Source ID | 897897e3-8fd8-4dea-b31e-36ab265c047c |
| Board ID | 897897e3-8fd8-4dea-b31e-36ab265c047c |
| Provider | paycom |
| Provider Job Key | 244685 |
| Title | Utilization Management Specialist |
| Normalized Title | — |
| Status | active |
| Active | yes |
| Location Text | — |
| Department | — |
| Team | — |
| Employment Type | — |
| Workplace Type | remote |
| Remote Policy | remote |
| Country | United States |
| Region | — |
| City | — |
| Salary Raw | $22.50 - $33.04 Hourly |
| Salary Min | 22.5 |
| Salary Max | 33.04 |
| Salary Currency | USD |
| Salary Period | hour |
| Source URL | https://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=244685&clientkey=8A60330E4601A7C93B62D516356235C3 |
| Apply URL | https://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=244685&clientkey=8A60330E4601A7C93B62D516356235C3 |
| First Seen At | 2026-05-31 19:06:37Z |
| Last Seen At | 2026-06-06 09:54:06Z |
| Last Checked At | 2026-06-06 09:54:06Z |
| Last Changed At | 2026-06-04 10:04:51Z |
| Inactive At | — |
| Source Posted At | 2026-03-27 00:00:00Z |
| Source Updated At | — |
| Raw Payload Uri | s3://job-postings-prod-raw-590183727216/raw/provider=paycom/board=8A60330E4601A7C93B62D516356235C3/date=2026-06-06/2026-06-06T09-54-04-103Z-a443c0e7cf1d0b4c7cd68fc7da9d97bfb91d9a6260a626c980af4bbac33c54bb.json |
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"description": "<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{6}\" paraid=\"1703206432\"><span style=\"display:block;font-size:14px;\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><u><strong>Who You’ll Join</strong></u></span></span></p>\r\n\r\n<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{8}\" paraid=\"764431894\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">At <strong>Santiam Hospital & Clinics</strong>, we believe exceptional patient care starts with a supportive and inclusive work environment. We empower every team member by providing access to advanced medical technology and continuous professional development. Join our collaborative culture, where your contributions are valued and your growth is encouraged. </span></span></p>\r\n\r\n<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{10}\" paraid=\"1413910595\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Come join our <strong>Utilization Management</strong> team as our new <strong>Utilization Management Specialist </strong>where you will play a critical role in ensuring patients receive the right care at the right time. Using clinical expertise and strong payer collaboration, this role drives timely authorizations, supports medical necessity decisions, and ensures compliance with CMS and payer guidelines. It’s an ideal opportunity for detail driven professionals who want to influence quality outcomes and support providers, while making a meaningful impact across the continuum of care. </span></span></p>\r\n\r\n<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{14}\" paraid=\"1490034585\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Take the next step in your healthcare career—apply today and bring your expertise to <strong>Santiam Hospital & Clinics</strong>, recently honored as <em><strong>2025’s Best Hospital in the Willamette Valley</strong></em>! </span></span></p>\r\n\r\n<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{16}\" paraid=\"1129915308\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\"><strong>Position Schedule:</strong> Monday – Friday, 8:00 am – 12:00 pm</span><span style=\"display:block;font-size:14px;\"><strong style=\"font-size: 13px;\">Salary range:</strong><span style=\"font-size: 13px;\"> $22.50 - $33.04 </span></span></span></p>\r\n\r\n<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{22}\" paraid=\"880126982\"> </p>\r\n\r\n<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{22}\" paraid=\"880126982\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\"><u><strong>What You’ll Do: </strong></u></span></span></p>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"1\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{24}\" paraid=\"346046620\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Performs clinical chart reviews for appropriate admissions, continued stays, and supportive services to promote quality care and full and accurate capture of revenue. </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"2\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{26}\" paraid=\"1658540825\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Ensure compliance with CMS, state, and payer-specific utilization review requirements </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"3\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{28}\" paraid=\"319801674\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Submit and monitor payer notifications for admissions, continued stay, and changes in status </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"4\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{30}\" paraid=\"1604969021\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Follow authorizations from initial notification through approval and additional authorized days, including entering and monitoring approved bed days in UM navigator </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"5\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{32}\" paraid=\"324611458\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Proactively engaged in obtaining auth approvals and continued follow-up as needed for approval/denials </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"6\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{34}\" paraid=\"1597211790\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Communicates with insurance companies regarding the medical necessity of admissions and provides clinical documentation and reviews as requested for purposes of ongoing authorization of hospital stays. </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"7\" data-font=\"Symbol\" data-leveltext=\"\" 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style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Communicate with the attending physician or nursing staff, when needed, to address the appropriate level of care, and order changes. </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"9\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{40}\" paraid=\"790376232\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Collaborate with CML and UM staff to deliver appropriate Medicare forms to patients when required (e.g., Code 44, Code W2, and Hospital Issued Notices of Non-Coverage). </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"10\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{42}\" paraid=\"1732889747\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Keeps Patient Registration and Patient Financial Services informed of any changes in admission status, working toward accurate capture of admission status prior to initial billing. </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"11\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{44}\" paraid=\"356123223\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Continually assesses clinical services for appropriateness for continued stay. </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"12\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{47}\" paraid=\"1836612710\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Serves as a resource and actively provides education for physicians related to Medicare and third-party payor billing requirements, correct admission status, and documentation supporting medical necessity. </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"13\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{49}\" paraid=\"1112099102\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Participates in the Utilization Review Committee. </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"14\" data-font=\"Symbol\" data-leveltext=\"\" data-list-defn-props=\"{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"multilevel"}\" data-listid=\"1\" role=\"listitem\">\r\n\t<p paraeid=\"{6c8185b2-a916-435d-83ea-5765ce78f725}{51}\" paraid=\"277277613\"><span style=\"font-family:Arial,Helvetica,sans-serif;\"><span style=\"display:block;font-size:14px;\">Assists UM RN Lead in medical necessity denial and appeals processes, ensuring prompt and accurate follow-up to ensure resolution and timely billing. </span></span></p>\r\n\t</li>\r\n</ul>\r\n\r\n<ul role=\"list\">\r\n\t<li aria-setsize=\"-1\" data-aria-level=\"1\" data-aria-posinset=\"15\" data-font=\"Symbol\" data-leveltext=\"\" 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Our commitment to excellence in patient care is matched by our dedication to employee growth and well-being. As part of our team, you’ll have access to cutting-edge medical technology, ongoing professional development opportunities, and a collaborative culture that encourages innovation and teamwork. Join us at Santiam Hospital & Clinics, where your skills and compassion will be appreciated, and together, we can make a positive impact on the health and lives of our community. </span></span></p>\n\n<p><span style=\"display:block; font-size:14px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">With 12 clinics offering 8 specialties, you’ll be part of a diverse and dynamic healthcare community. 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},
"detail_meta": {
"url": "https://portal-applicant-tracking.us-cent.paycomonline.net/api/ats/job-postings/244685",
"http_status": 200,
"content_type": "application/json",
"response_bytes": 56416
},
"detail_errors": []
}Get this page with API
Rendered from the bluedoor Job Postings API. Reproduce it:
GET https://api.bluedoor.sh/job-postings/v1/jobs/c1916fbaa22190f11a6a75b6d63e9f89e035e8d7?include=descriptionJSONGET https://api.bluedoor.sh/job-postings/v1/orgs/b6a98371-73be-4a26-959b-eb95323deddaJSONGET https://api.bluedoor.sh/job-postings/v1/sources/897897e3-8fd8-4dea-b31e-36ab265c047cJSONGET https://api.bluedoor.sh/job-postings/v1/jobs/c1916fbaa22190f11a6a75b6d63e9f89e035e8d7/eventsJSON