Global Recruiters of Moon Valley (GRN)
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 Cultural Advocate:
Promote culturally and religiously sensitive care across diverse patient populations Essential Functions 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 Establish and maintain referral agency relationships to support timely and effective patient discharges Qualifications 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 Demonstrated strength in systems thinking, data-driven decision making, and operational problem solving Compensation and Benefits 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 Voluntary benefits and robust well-being resources Why This Role 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.
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 Cultural Advocate:
Promote culturally and religiously sensitive care across diverse patient populations Essential Functions 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 Establish and maintain referral agency relationships to support timely and effective patient discharges Qualifications 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 Demonstrated strength in systems thinking, data-driven decision making, and operational problem solving Compensation and Benefits 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 Voluntary benefits and robust well-being resources Why This Role 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.