Clinical Product Consultant - utilization management

ABOUT THIS POSITION

The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide clinical insight into product development and testing and have an active role in implementation and delivery of the product, interacting with customer end users and managers. The Consultant will be responsible for ensuring that the complexity of our AI technology is married with the clinical perspective and needs of our clients through data analysis and auditing.

They will also be responsible for end user adoption of best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as an integral contributor in the delivery of AwareUM to our clients.

• 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.

• 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 Inter Qual products and services.
• Experience in the software training and education for health-care related products.
• Knowledge of core software applications including Google, Excel, Power Point.

Waystar helps providers simplify healthcare payments and yield powerful results throughout the complete revenue cycle with a cloud-based technology platform. The platform is trusted by over 1 million providers, 1,000 health systems, and 5,000 payers and health plans. It is committed to living out its organizational values: honesty, kindness, passion, curiosity, fanatical focus, best work always, making it happen, and joyful, optimistic fun.

• Competitive total rewards (base salary plus bonus if applicable).
• Customizable benefits package with three medical plans and a Health Savings Account company match.
• Generous paid time off for non-exempt team members starting with three weeks plus 13 paid holidays, including two personal floating holidays. Exempt members receive flexible time off plus 13 holidays.
• Paid parental leave, including maternity and paternity leave.
• Education assistance opportunities and free Linked In Learning access.
• Free mental health and family planning programs, including adoption assistance and fertility support.
• 401(K) program with company match.
• Pet insurance.
• Em…