Manager, Clinical Utilization Management & Transitions of Care
CHPWSeattle, Washington, United States
Posted April 28, 2026
Full Time
About the Company
CHPW Careers represents the career hub for the Community Health Plan of Washington, a 30‑year‑old not‑for‑profit managed care organization that pioneered community‑based health insurance for Washington families. The company delivers health insurance, managed care, medical management, and Medicare/Medicaid services, while offering translation and culturally competent care statewide. It distinguishes itself by being the sole not‑for‑profit provider for Apple Health members and by extending care beyond clinical services to include food, housing, and transportation assistance. Employees thrive in a community‑first culture rooted in local health centers, focused on improving access for underserved populations.
Job Description
Manager, Clinical Utilization Management & Transitions of Care in Seattle, WA, United States: leads utilization management, inpatient medical necessity reviews, and transitions of care efforts. Develops and optimizes workflows to ensure regulatory compliance, operational efficiency, and high-quality member outcomes.
Requirements
- Hold a current, unrestricted RN license in the State of Washington.
- Have a bachelor’s degree in nursing or an advanced clinical degree, or additional advanced clinical training, preferred.
- Have a minimum of three (3) years UM or CM experience required.
- Have a minimum of three (3) years leading teams required, experience working with remote workers desired OR a minimum of three (3) years in a supervisory or management role required.
- Have a minimum of three (3) years acute or ambulatory clinical experience in a medical/surgical or pediatric setting required.
- Possess a valid WA driver's license and have access to a reliable automobile.
Benefits
- Medical, Prescription, Dental, and Vision
- Telehealth app
- Flexible Spending Accounts, Health Savings Accounts
- Basic Life AD&D, Short and Long-Term Disability
- Voluntary Life, Critical Care, and Long-Term Care Insurance
- 401(k) Retirement and generous employer match
- Employee Assistance Program and Mental Fitness app
- Financial Coaching, Identity Theft Protection
- Time off including PTO accrual starting at 17 days per year.
- 40 hours Community Service volunteer time
- 10 standard holidays, 2 floating holidays
- Compassion time off, jury duty pay.