Clinical Product Consultant - utilization management

Waystar is a healthcare payments platform that simplifies revenue cycle management for providers. The Clinical Product Consultant for Utilization Management will provide clinical insights into product development and implementation, ensuring that the needs of clients are met through effective use of the AwareUM technology.

Responsibilities:

• Collaborate with the product and services teams to execute our strategic plan for AwareUM
• Audit for product accuracy and effectiveness, communicating with product for change as identified
• Assess effectiveness of AwareUM technology in creating efficient workflow for UM nurses
• Deliver on go-forward product milestones balancing client requests with investment in new capabilities that deliver on the vision for the product
• Collaborate with the UM growth team and support a smooth sales delivery process that results in achievement of targeted growth expectations
• Collaborate with the CX team to create a seamless, integrated, and consistent user experience
• Actively manage the client experience to deliver on implementation milestones, manage client support requests and expectations and monitor client successful use of the product

Requirements:

• Bachelor of Science in Nursing (BSN) or equivalent (with RN licensure)
• 8+ years of clinical experience in acute care setting
• 2+ years of experience in utilization management
• Knowledge and understanding of Utilization Management, Quality Management, Care Management, and/or Chronic Condition Management within hospital systems, post-acute providers, and/or payers
• Demonstrates an understanding of evolving reimbursement models, including commercial payers, Medicaid, and Medicare
• Demonstrates an understanding of CMS and payer regulations as it pertains to patient status and care management
• Works effectively on a multidisciplinary team
• Demonstrates flexible, positive, clear interpersonal and communication skills with ability to facilitate the exchange of information with internal and external clients
• Ability to work remotely, effectively, and efficiently
• Proven history of collaborative, team-focused approach
• Excellent oral and written communication skills
• Ability to travel 20-50% of the time, to domestic locations for client or business meets
• Experience leading a Utilization Management team in an acute care setting
• Active and current Utilization and/or Case Management Certification
• 2-3 years' experience with MCG and/or InterQual products and services
• Experience in the software training and education for health-care related products preferred
• Knowledge of core software applications including google, excel, power point