PERMANENT

FULL_TIME

ADAPTED_NOW

HOUR

Jamestown Salish Seasons is seeking a Utilization Management Specialist (UMS) to support insurance coordination, utilization management, authorization processes, provider credentialing, and revenue cycle operations within our residential behavioral health program. Assist with denial management activities, including scheduling peer-to-peer reviews and facilitating communication between providers and payors.

Jamestown Salish Seasons is seeking a Utilization Management Specialist (UMS) to support insurance coordination, utilization management, authorization processes, provider credentialing, and revenue cycle operations within our residential behavioral health program. This role serves as a key internal resource for insurance and billing operations while supporting continuity of care and program sustainability. The UMS works collaboratively with clinical, operational, and administrative teams to ensure timely authorizations, accurate reimbursement processes, and compliance with regulatory and payor requirements. The ideal candidate is highly organized, detail-oriented, and experienced in healthcare operations, insurance workflows, and behavioral health environments. This position contributes to a trauma-informed, recovery-oriented, and culturally respectful environment aligned with the mission and values of the Jamestown S’Klallam Tribe. At JSS, we are committed to providing compassionate, culturally respectful, and recovery-oriented care in a supportive residential setting. Team members play an important role in supporting both resident wellness and organizational sustainability. ﻿Essential FunctionsUtilization Management & Insurance Coordination<ul><li>Serve as an internal resource regarding insurance coverage, authorizations, and utilization management requirements</li><li>Coordinate with Managed Care Organizations (MCOs), commercial insurance companies, and other payors regarding treatment authorizations and continued stay reviews</li><li>Support timely submission of clinical and administrative documentation to maintain authorization compliance</li><li>Assist with denial management activities, including scheduling peer-to-peer reviews and facilitating communication between providers and payors</li><li>Monitor authorization status and communicate updates to appropriate team members</li></ul>Revenue Cycle Support<ul><li>Coordinate insurance verification, authorization tracking, claims submission, and payment posting within the electronic health record (EHR) system</li><li>Monitor claims, denials, payment variances, and reimbursement trends</li><li>Identify and resolve issues contributing to payment delays, denials, or revenue cycle inefficiencies</li><li>Collaborate with internal teams and external partners to support efficient reimbursement processes</li><li>Ensure billing and documentation processes comply with regulatory, organizational, and payor requirements</li></ul>Provider Credentialing & Compliance<ul><li>Coordinate provider credentialing, recredentialing, and enrollment activities</li><li>Monitor provider licensure, DEA renewals, and related credentialing requirements</li><li>Maintain accurate credentialing and compliance records</li></ul>Operational Support & Team Collaboration<ul><li>Train and support staff on insurance, authorization, and billing workflows</li><li>Provide backup support for referral coordination and front desk operations as needed</li><li>Maintain accurate and timely documentation related to insurance and billing coordination</li><li>Participate in meetings, trainings, and quality improvement initiatives</li><li>Communicate professionally with residents, families, payors, and community partners</li></ul>QualificationsRequired<ul><li>Minimum of three (3) years of experience in:</li><li>Utilization management</li><li>Insurance authorization</li><li>Medical billing</li><li>Revenue cycle operations</li><li>Provider credentialing</li><li>Healthcare administration or related healthcare operations</li><li>Knowledge of:</li><li>Utilization management processes</li><li>Insurance authorization requirements</li><li>Claims submission and payment posting</li><li>Revenue cycle operations</li><li>Provider credentialing workflows</li><li>Proficiency with EHR systems, billing software, payor portals, and standard office technology</li><li>Strong organizational, communication, and problem-solving skills</li><li>Ability to manage multiple priorities in a fast-paced environment</li><li>Understanding of HIPAA, 42 CFR Part 2, and confidentiality requirements</li><li>Valid driver’s license</li><li>Ability to pass a criminal background investigation</li></ul>Preferred Qualifications<ul><li>Associate degree in healthcare administration, business, accounting, medical office administration, or related field</li><li>Experience working in behavioral health, residential treatment, psychiatric, substance use disorder, or inpatient healthcare settings</li><li>Experience with provider credentialing and payor enrollment processes</li><li>Experience training staff on operational and billing workflows</li><li>Experience working with tribal health programs, tribal communities, or underserved populations</li><li>Understanding of culturally responsive and recovery-oriented care practices</li></ul>Additional Information<ul><li>Employment is contingent upon successful completion of a criminal background investigation</li></ul>

Jamestown S'Klallam Tribe

Utilization Management Specialist

Administrator Documentation

Background Investigation

Behavioral Health

Billing

Billing Records

Billing Software

Business Continuity Planning (BCP)

Clinical Study Publications

Code of Federal Regulations

Communication Skills

Detail Oriented

Driver's License

Financial Trend Analysis

HIPAA (Health Insurance Portability and Accountability Act)

Health Insurance

Healthcare

Healthcare Administration

Identify Issues

Insurance

Insurance Documentation

Internet Application

Maintain Compliance

Managed Care

Medical Billing

Medical Office Administration

Medical Record System

Multitasking

Operational Support

Organizational Skills

Patient Care

Patient Care Authorizations

Payment Posting

Problem Solving Skills

Provider Credentialing

Psychiatry and Mental Health

Quality Assurance

Quality Management

Regulations

Regulatory Compliance

Reimbursement

Staff Training

Sustainability

Time Management

Unified Messaging Services (UMS)

United States Drug Enforcement Agency (DEA)

Utilization Management

monster

Leveraging clinical knowledge, this position supports computer applications, educates and provides continuous support to staff in their use of the Electronic Health Record, and may contribute to the development of workflows related to direct patient care and appointment preparation. Excellent organizational skills with the demonstrated ability to effectively prioritize multiple tasks and manage workload efficiently.

The Clinical Informatics I position plays a vital role in bridging the gap between clinical practice, computer science, and information technology within Jamestown HealthCARE. This full-time position is responsible for managing healthcare data and information to optimize clinical operations and enhance the utilization of our Electronic Medical Records (EMR) Systems. The Clinical Informatics I will focus on creating comprehensive process documentation, developing Standard Operating Procedures (SOPs), improving existing workflows, and ensuring the standardization of practices, including the oversight of our document control system. This role involves providing essential training and ongoing support for all EMR systems utilized across Jamestown HealthCARE facilities. The Clinical Informatics I will also collaborate closely with Jamestown HealthCARE Management to develop and implement efficient clinical workflows. Leveraging clinical knowledge, this position supports computer applications, educates and provides continuous support to staff in their use of the Electronic Health Record, and may contribute to the development of workflows related to direct patient care and appointment preparation. Responsibilities:<ul><li>Create and manage employee user access for EMR Systems, electronic health records, billing systems, and all integrated applications.</li><li>Develop and deliver comprehensive training programs on electronic health records and associated applications for staff.</li><li>Serve as a primary point of contact for end-user support requests related to EMR and other clinical systems, providing timely and effective solutions.</li><li>Collaborate with the Clinical Informatics L2 and Supervisor to thoroughly research and troubleshoot issues related to the EMR and other integrated systems.</li><li>Facilitate discussions with EMR vendors, as directed and approved by the Supervisor, to address system issues and explore potential enhancements.</li><li>Develop and document quality assurance workflow processes and create user-friendly guidebooks to support staff adoption.</li><li>Coordinate the distribution of training and informational materials to end users, ensuring accuracy and accessibility, as approved by the Supervisor.</li><li>Strictly adhere to all Jamestown S’Klallam Tribe policies and procedures, including maintaining a safe work environment and ensuring compliance with HIPAA regulations.</li><li>Perform other duties as assigned to support the efficient operation of Jamestown HealthCARE.</li></ul> Qualifications:<ul><li>Associate of Arts (AA) degree or two (2) years of equivalent healthcare experience in lieu of the AA degree.</li><li>Minimum of two (2) years of practical experience working with electronic health record and billing systems in a healthcare setting.</li><li>Demonstrated knowledge and understanding of healthcare terminology, healthcare coding (e.g., ICD-10, CPT), and healthcare billing processes.</li><li>Proven ability to comprehend and consistently follow established office protocols and policies.</li><li>Knowledge of relevant Local, State, and Federal Laws and Regulations pertaining to the certification of electronic health records and billing systems.</li><li>Exceptional interpersonal skills with the ability to communicate effectively, both verbally and in writing, with a diverse range of individuals.</li><li>Understanding of general office administrative operations, including basic principles of personnel management and compliance requirements.</li><li>Excellent organizational skills with the demonstrated ability to effectively prioritize multiple tasks and manage workload efficiently.</li><li>Effective time management, decision-making, and problem-solving skills.</li><li>Ability to demonstrate initiative and work independently with minimal supervision.</li><li>Proficiency in the Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).</li><li>Ability to travel locally and regionally as required for training or meetings.</li><li>Possession of a valid Driver’s License.</li><li>Successful completion of a criminal background check is required prior to employment.</li></ul> Preferred Qualifications:<ul><li> American Indian/Alaska Native preferences apply.</li><li>Current WA State licensure, certification, or credentialing in a professional healthcare-related field.</li><li>Previous experience leading group training sessions or teaching end-users on software applications.</li><li>Formal credentialing in electronic health record and billing processes.</li></ul>

Clinical Informatics I

Address Management

Administrative Skills

Clinical Facilities

Clinical Information

Clinical Information Systems

Computer Science

Control Systems

Current Procedural Terminology (CPT)

Data Management

Distribution Management

Document Control

Documentation Standards

Electronic Medical Records

Establish Priorities

Federal Laws and Regulations

Health Informatics

Health Information Management

Health Information Technology

Healthcare Management

Help Desk

ICD-10

Interpersonal Skills

Leadership

Microsoft Excel

Microsoft Office

Microsoft Outlook

Microsoft PowerPoint

Microsoft Word

People Management

Process Development

Quality Assurance Methodology

Safety/Work Safety

Software Administration

Standard Operating Procedures (SOP)

State Laws and Regulations

System Integration (SI)

Team Lead/Manager

Training Program

Training/Teaching

Willing to Travel

YEAR

This role oversees the general ledger, month-end close, financial statement preparation, internal controls, and key transactional workflows—with heightened accountability for accurate payroll and timely, accurate accounts payable processing. You will supervise all accounting staff, which include Account Payable Coordinator, Payroll Coordinator, Staff Accountant and Senior Accountants, provides functional leadership to finance operations processes.

At Island Health, people are at the center of everything we do. As a part of the Accounting/ Finance team, you’ll play a vital role in supporting our mission to care for those who care for others. You’ll help create a positive and seamless experience for every team member — ensuring they feel valued, supported, and heard. As our Controller, you will lead the hospital’s accounting operations and ensures the integrity, accuracy, and timeliness of the organization’s financial records and reporting. This role oversees the general ledger, month-end close, financial statement preparation, internal controls, and key transactional workflows—with heightened accountability for accurate payroll and timely, accurate accounts payable processing. The Controller develops and maintains efficient, standardized processes that reduce error risk, strengthen compliance, and support Island Hospital’s mission, strategic goals, and long-term financial sustainability. Location: Anacortes, WA / OnsiteSchedule: Full Time / DaysSalary: $46.29/hr. ($96,279 annually) - $69.44/hr. ($ 144,440 annually) What you will be doing:<ul><li>You will supervise all accounting staff, which include Account Payable Coordinator, Payroll Coordinator, Staff Accountant and Senior Accountants, provides functional leadership to finance operations processes.</li></ul>Financial Reporting, Close, and GAAP Compliance<ul><li>Lead monthly, quarterly, and annual close to produce timely, accurate, and complete financial statements in accordance with GAAP and applicable state/federal requirements.</li><li>Oversee general accounting activities including general ledger, revenue recording, accounts payable/receivable support, and related reconciliations.</li><li>Ensure consistent application of accounting procedures and effective bookkeeping practices across the department.</li><li>Analyze complex financial data, resolve inconsistencies, and provide clear, actionable reporting to leaders (and Board-facing support as needed).</li><li>Attend monthly Finance Committee meeting and take minutes</li></ul>Payroll Accuracy, Controls, and Risk Reduction<ul><li>Oversee payroll accounting processes to ensure payroll is accurate, fully supported, and properly recorded in the general ledger, with timely reconciliations and issue resolution.</li><li>Ensure all pay rules are in alignment with all employee contracts including collective bargaining agreements.</li><li>Partner with the Office of Talent Management to ensure reliable employee data flow (e.g., hires, terminations, job changes, leave), and to strengthen end-to-end internal controls that reduce payroll error risk.</li><li>Design verification and review controls (pre- and post-payroll), including reconciliations, exception reporting, and documentation standards to reduce manual error and rework.</li></ul>Accounts Payable Timeliness and Process Reliability<ul><li>Oversee AP workflows to ensure invoices are processed accurately and on time, aligned with approval policies, contract terms, and cash management priorities.</li><li>Strengthen invoice routing/approval, matching/validation, vendor file controls, and exception handling to reduce delays and payment errors.</li><li>Implement efficiency improvements and clear SOPs that reduce cycle time, prevent duplicate/incorrect payments, and improve throughput—especially during staffing transitions.</li></ul>Internal Controls, Audit Readiness, and Documentation<ul><li>Maintain and continuously improve the internal control structure through documentation, education, monitoring, and enhancements.</li><li>Evaluate and document accounting policies and emerging reporting issues; prepare written support (“white papers”) and audit-ready documentation for key judgments and controls.</li><li>Coordinate external audits and required reporting support, including tax-related items as applicable to the organization.</li><li>Ensure compliance with applicable regulations, hospital policies, and payer/government reporting requirements as applicable.</li><li>Maintain and improve internal controls over financial reporting, cash handling, payroll accounting, and disbursements.</li></ul>Regulatory and Reimbursement Support (as assigned)<ul><li>Provide accounting support and coordination for Medicare/Medicaid cost report preparation and related audit requests, ensuring accurate inputs, reconciliations, and support schedules.</li></ul>Budgeting, Forecasting, and Capital Planning Support<ul><li>Support development of forecasting models, the annual budget process, and multi-year capital planning through accurate actuals, sound assumptions, and well-documented analyses.</li></ul>Treasury and Investment Accounting Support<ul><li>Provide accounting and reporting support for treasury-related activities and investment reporting, including performance analysis against benchmarks where applicable.</li></ul>Performance Management and Continuous Improvement<ul><li>Establish and monitor performance dashboards for finance operations (e.g., close timeliness, reconciliation completion, AP cycle time, payroll corrections/error rates) and lead continuous improvement efforts.</li><li>Promote a proactive, collaborative team culture emphasizing respect, quality, customer service, innovation, and teamwork.</li></ul>Team Leadership & Collaboration<ul><li>Supervise and develop accounting staff; set clear expectations, provide coaching, and ensure appropriate workload management.</li><li>Work collaboratively with leaders across the hospital to support accurate coding of expenses, timely information flow, and resolution of accounting issues.</li></ul> What you will bring to the role: <ul><li>Strong quantitative, project management, communication, and leadership skills.</li><li>Strong writing and documentation skills, including ability to support accounting interpretations and internal control/audit requirements.</li><li>Ability to research, analyze, interpret complex data, and formulate recommendations; ability to identify and resolve inconsistencies.</li><li>Ability to communicate complex concepts clearly across varying levels of expertise and prepare high-impact presentations for leadership/stakeholders as needed.</li><li>Systems-thinking and comfort operating in ambiguity; collaborative relationship-building across departments and external partners.</li><li>Ability to interpret contract/legal documentation and apply it to financial processes (especially AP and payroll controls).</li></ul> Your Qualifications:<ul><li>Bachelor’s degree in accounting, Finance, or related field required (Master’s preferred).</li><li>Minimum of 5 years of progressive accounting experience; healthcare/hospital experience strongly preferred.</li><li>Demonstrated experience leading month-end close, reconciliations, financial reporting, and internal controls.</li><li>Strong understanding of payroll accounting and AP workflows, including risk controls and process design.</li><li>Proficiency with accounting systems/ERPs and advanced Excel skills.</li></ul> Make a Difference with UsAt Island Health, every role contributes to our mission of compassionate, high-quality care. Join us and help create a workplace where every team member feels valued and supported.  Why You’ll Love Working HereWe believe in taking care of our people so they can take care of others. When you join Island Health, you’ll enjoy a culture that values integrity, compassion, teamwork, and growth — plus a robust benefits package that includes:<ul><li>Comprehensive Medical, Dental, and Vision Insurance</li><li>Generous Paid Time Off and Extended Illness Benefits</li><li>Life Insurance and Long-Term Disability Coverage</li><li>Vested Retirement Contributions and Flexible Spending Accounts</li><li>Tuition Reimbursement and Student Loan Repayment Programs</li><li>Employee Recognition Events and a supportive, community-focused team</li></ul> Ready to Apply?Apply today and take the next step in your career with Island Health.

Island Hospital

Controller

Accounting

Accounting Close

Accounting Policies

Accounting Software

Accounts Payable

Accounts Receivable

Analysis Skills

Benchmarking

Bookkeeping

Budgeting

Cash Management

Coaching

Collective Bargaining

Community Support

Continuous Improvement

Contract Approval

Customer Support/Service

Design Verification

Disbursements

Documentation

Error Handling

Finance

Financial Analysis

Financial Control

Financial Operations

Financial Reporting

Financial Statements

Forecasting

General Ledger Accounting

Generally Accepted Accounting Principles (GAAP)

Hospital

Internal Audit

Investment Accounting

Investment Reporting

Medicaid

Medical Coding

Medicare Cost Reports

Meeting Minutes

Operations Processes

Payroll Accounting

Payroll Administration

Payroll Management

Performance Analysis

Performance Management

Project/Program Management

Reconciliation

Reporting Dashboards

Research Skills

Revenue/Sales Reporting

Risk Management

Talent Management

Team Player

Treasury

Treasury Accounting

Writing Skills

Knowledge of specific legal statutes (State and Federal), requirements of DNV, DOH and other regulatory bodies, and Medical Staff Bylaws as they relate to Physician Credentialing, Peer Review, Physician Quality Assurance, and other hospital/interdepartmental functions, is necessary. Interactions with regional and corporate colleagues with MSO/Credentialing responsibilities and internal (credentialed providers, hospital departments, CVO etc) and external (managed care agencies, general public, etc.) customers.

We’re seeking a Medical Staff Coordinator to join our Quality & Risk Management Office—the department that ensures all providers are properly credentialed and privileged to deliver safe, high-quality care. If you’re organized, detail-driven, and want to make a meaningful impact behind the scenes in healthcare, this role offers an excellent opportunity to grow your career! At Island Health, people are at the center of everything we do. As a part of the Quality & Risk Management Team, you’ll play a vital role in supporting our mission to care for those who care for others. You’ll help create a positive and seamless experience for every team member — ensuring they feel valued, supported, and heard. <ul><li>Location: Anacortes, WA, Onsite</li><li>Schedule: Full Time / 40 hours per week</li><li>Salary Range: $38.55 – $56.23 per hour</li></ul>For Information on <a href="https://islandhealth.org/wp-content/uploads/2022/11/Employee_Benefits_Summary_2024.pdf" rel="noopener noreferrer nofollow" target="_blank">Employee Benefits</a> In the Medical Staff Coordinator role, you will play a key role for the facilitation and coordination of medical staff administrative activities for the organized medical staff and practitioner credentialing and privileging processes in compliance with medical staff bylaws, policies, accreditation standards, and regulatory requirements. The Medical Staff Coordinator works with Hospital and Physician leaders to facilitate compliance with medical staff governing documents, regulatory requirements, and accreditation standards related to medical staff activities. In collaboration with physician and hospital leadership, this position will coordinate the administrative support services for the medical staff to ensure activities are effectively implemented to support the required functions of the organized medical staff. What you will be doing:<ul><li>Responsible for the administration of the medical staff organization and serves as an essential link between senior management and the medical staff to promote and enhance good communication and a positive working relationship.</li><li>Ensures compliance with the accrediting and regulatory agencies in regards to credentialing while developing & maintaining a working knowledge of the statutes and laws.</li><li>Maintains a working knowledge of the medical staff bylaws, rules and regulations and laws.</li><li>Responsible for establishing, contributing to and maintaining continuity in the planning, development and implementation of standards applicable to the medical staff organization, relating to credentialing, quality and administrative functions.</li><li>Coordinates insurance credentialing process for all providers that Island Hospital bills insurances for professional fees. This process includes working with providers to ensure documentation is completed in a timely manner, submitting information to the credentialing service, tracking progress of credentialing service for timeliness and communicating to managers the status of the provider’s credentialing on a weekly basis.</li><li>Responsible for monitoring budget expenses for the department.</li><li>Develops operational plans and assures development of and compliance with operating and capital budgets and achievement of financial performance.</li><li>Interactions with regional and corporate colleagues with MSO/Credentialing responsibilities and internal (credentialed providers, hospital departments, CVO etc) and external (managed care agencies, general public, etc.) customers.</li><li>Responsible for coordination and preparation of medical staff functions; prepared for and coordinates the continuing medical education program.</li><li>Performs bookkeeping activities for the medical staff</li><li>Ensures that all expirables (licenses, insurance, certifications etc.) are reviewed, obtained and managed on a monthly basis according to the rules and policies.</li><li>Maintains the confidentiality of all business/work and medical staff information</li><li>Manages the flow of information between administration, credentials, MEC members, Medical Staff leadership (including Service, Department and Section Chairpersons) and the Chief of staff.</li><li>Maintains MEC Educational Contracts</li><li>Conducts physician orientation for new/prospective providers</li><li>Liaison between legal department and the medical staff committees and Chief of Staff</li><li>Processing of physician credentials for initial appointment/reappointment</li><li>Enters/Maintains physician data in Meditech (Privileged and non-privileged providers (1200+ providers annually).</li><li>Collects and tracks Medical staff dues. </li><li>Organizes and coordinates regular (14) and ad hoc meetings for the Medical Staff. Prepares records, such as minutes, notices and memorandums for medical staff meetings.</li><li>Acts as custodian for medical staff documents and records.</li><li>Prepares memorandums outlining any changes in policies, procedures, bylaws rules and regulations.</li><li>Prepares correspondence as requested from committee chairs for peer review follow-up.</li><li>Acts as liaison between administration and the medical staff by handling communications such as letters from the medical staff to administration or from administration to medical staff. Also handles appointment setting and meeting logistics between administrators and physicians as requested.</li><li>Develops monthly calendars; medical staff, ER, admitting physician EKG calendar.</li><li>Maintain MSO physician database of 200+ providers (PrivPlus)</li><li>Maintains on-line Medical Staff directory and clinical privileges. </li><li>Generates Physician Profile Reports for re-credentialing.</li><li>Process reference/verification requests from other hospitals, credentialing agencies, state departments and specialty boards.</li><li>Facilitates effective peer review and tracks actions and correspondence.</li><li>Must have demonstrated ability to interact positively with Administration, Directors, Managers, Supervisors, peers, co-workers, subordinates, patients and visitors.</li><li>Must meet regular attendance standard and must stay at or below average sick leave utilization levels.</li></ul> What you will bring:<ul><li>Position requires attention to detail along with effective organization and prioritization skills.</li><li>Must demonstrate exceptional interpersonal skills and work effectively and efficiently with healthcare professionals both in and out of the hospital environment</li><li>Must be self-motivated and demonstrate initiative with the ability to work independently; however open to take direction as appropriate.</li><li>Knowledge of specific legal statutes (State and Federal), requirements of DNV, DOH and other regulatory bodies, and Medical Staff Bylaws as they relate to Physician Credentialing, Peer Review, Physician Quality Assurance, and other hospital/interdepartmental functions, is necessary.</li><li>Ability to handle sensitive and confidential information regularly.</li></ul> Your Qualifications:<ul><li>A minimum of three (3) years of advanced administrative experience in a healthcare setting required with previous credentialing experience strongly preferred.</li><li>Associate Degree encouraged.</li><li>Certified Provider Credentialing Specialist (CPCS) strongly preferred.</li></ul> Make a Difference with UsAt Island Health, every role contributes to our mission of compassionate, high-quality care. Join us and help create a workplace where every team member feels valued and supported. Why You’ll Love Working HereWe believe in taking care of our people so they can take care of others. When you join Island Health, you’ll enjoy a culture that values integrity, compassion, teamwork, and growth — plus a robust benefits package that includes:<ul><li>Comprehensive Medical, Dental, and Vision Insurance</li><li>Generous Paid Time Off and Extended Illness Benefits</li><li>Life Insurance and Long-Term Disability Coverage</li><li>Vested Retirement Contributions and Flexible Spending Accounts</li><li>Tuition Reimbursement and Student Loan Repayment Programs</li><li>Employee Recognition Events and a supportive, community-focused team</li></ul> Ready to Apply?Apply today and take the next step in your career with Island Health.

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Utilization Management Specialist Jamestown S'Klallam Tribe

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