Clinical Product Consultant - Utilization Management

Clinical Product Consultant Utilization Management

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 as well 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.

What You'll Do

• 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.

What You'll Need

• 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.

Preferred Requirements

• 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.

About Waystar

Through a smart platform and better experience, Waystar helps providers simplify healthcare payments and yield powerful results throughout the complete revenue cycle. Waystar’s healthcare payments platform combines innovative, cloud-based technology, robust data, and unparalleled client support to streamline workflows and improve financials so providers can focus on what matters most: their patients and communities. Waystar is trusted by 1M+ providers, 1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid/Medicare payers. We are deeply committed to living out our organizational values: honesty; kindness; passion; curiosity; fanatical focus; best work, always; making it happen; and joyful, optimistic & fun. Waystar products have won multiple Best in KLAS® or Category Leader awards since 2010 and earned multiple #1 rankings from Black Book™ surveys since 2012. The Waystar platform supports more than 500,000 providers, 1,000 health systems and hospitals, and 5,000 payers and health plans. For more information, visit waystar.com or follow @Waystar on Twitter.

Waystar Perks

• Competitive total rewards (base salary + bonus, if applicable).
• Customizable benefits package (3 medical plans with Health Saving Account company match).
• Generous paid time off for non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. Flexible time off for exempt team members + 13 paid holidays.
• Paid parental leave (including maternity + paternity leave).
• Education assistance opportunities and free LinkedIn Learning access.
• Free mental health and family planning programs, including adoption assistance and fertility support.
• 401(K) program with company match.
• Pet insurance.
• Employee resource groups.

Waystar is proud to be an equal opportunity workplace. We celebrate, value, and support diversity and inclusion. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Key skills/competency

• Clinical Product Consultant
• Utilization Management
• Product Development
• AI Technology
• Data Analysis
• Auditing
• Workflow Optimization
• Client Experience
• Healthcare Payments
• RN