Utilization Management Clinician I
CHPWSeattle, Washington, United States
Posted December 19, 2025
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
This position is available fully remote in Washington state. The Utilization Management Clinician performs utilization review for medical or behavioral health requests using utilization review criteria, technologies, and tools. Identifies, coordinates, and implements high quality, cost-effective alternatives when appropriate to the patient’s condition.
Requirements
- Bachelor’s degree in a relevant field or an equivalent combination of education and highly relevant experience
- Current, unrestricted license as an RN or LPN
- At least two years clinical experience in either a physical health or behavioral health setting
- Previous experience in Utilization Management and Managed Care, preferred
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
