Spokane
Director of Care Management and Utilization Review- Multi-System Location: Pacific Northwest Health System Scope: Oversight of 2 hospitals | 500+ licensed beds Compensation: $150,000 – $230,000 base salary Relocation Assistance: Available Opportunity Overview We are partnering with a large, integrated hospital system in the Pacific Northwest to identify a Director of Care Management and Utilization Review. This is a high-impact leadership role overseeing care management and utilization review operations across multiple hospitals, serving as a strategic connector between clinical teams, physicians, payers, and community partners. This leader will drive seamless transitions of care from pre-admission through discharge, advocate for complex patient populations, and ensure the appropriate, efficient use of healthcare resources through evidence-based medical review and regulatory compliance. This opportunity is ideal for an accomplished RN leader who thrives at the intersection of clinical excellence, operational performance, and mission-driven leadership. You will influence system-level outcomes, strengthen physician partnerships, mentor high-performing teams, and use data and systems thinking to continuously improve quality, patient experience, and throughput. Position Overview In this role, you will serve as: • Master Coordinator: Direct and facilitate care management processes to ensure high-quality patient care and operational efficiency, • Champion of Continuity and Care Coordination: Ensure consistent clinical outcomes, advocate for patients, and manage resources to reduce fragmentation across the care continuum, • Communication Facilitator: Foster strong collaboration among physicians, nurses, interdisciplinary teams, payers, and external partners, • Lead teams in alignment with the organization’s Mission, Vision, and Core Values, • Develop and sustain a comprehensive departmental customer satisfaction program, • Recruit, develop, coach, and retain high-performing care management and utilization review staff, • Ensure compliance with infection control, risk management, confidentiality, and regulatory standards, • Foster a respectful, inclusive environment sensitive to cultural and religious diversity, • Ensure adherence to safety and security policies and procedures, • Oversee patient-centered care delivery across all age populations including neonates through older adults, • Develop and maintain departmental policies aligned with organizational, legal, and community standards, • Support departmental goal setting aligned with system-wide strategies, • Participate in annual budget planning and cost-effective resource utilization, • Oversee admission and discharge processes, including alternatives to non-qualifying inpatient admissions, • Build and maintain strong collaborative relationships with physicians, • Chair and lead the Utilization Management Committee, monitoring trends and outcomes, • Oversee contracted services and external partners to ensure quality and performance, • Bachelor’s Degree in Nursing required; Master’s Degree preferred, • Active Registered Nurse background with at least 2 years of acute care clinical experience, • Minimum of 3 years of leadership experience in care coordination or care management, • Utilization review experience strongly preferred, • Proven ability to work independently while leading complex teams and initiatives, • Competitive base salary range of $150,000 – $230,000, • Relocation assistance available, • Comprehensive benefits package including:, • 401(k) savings plan with employer match, • Medical, dental, and vision coverage, • Life and disability insurance, • Paid parental leave, vacation, holidays, and sick time This is a rare opportunity to lead care management and utilization review at scale within a mission-driven health system. You will have executive visibility, system-level influence, and the opportunity to shape the future of care delivery while improving patient outcomes, experience, and operational performance.