Clinical Product Consultant – Utilization Management

🕒 June 30

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Waystar

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

☁️ SaaS

🤖 Artificial Intelligence

🔥 Funding within the last year

💰 $709.2M Post-IPO Secondary - Waystar on 2025-09

Healthcare • SaaS • Artificial Intelligence

Waystar is an AI-powered healthcare revenue cycle software company that provides a unified, cloud-based platform to simplify healthcare payments and automate the end-to-end revenue cycle for healthcare providers. Its platform covers financial clearance (eligibility verification, patient estimation, prior authorizations), patient financial care, clinical integrity and revenue capture (charge and DRG anomaly detection), claim and payer payment management, denial recovery, and analytics and reporting, with integrations to EHRs and payer systems. Waystar serves hospitals, health systems, physician and specialty practices, ambulatory surgery centers, and other provider organizations, leveraging agentic, generative, and predictive AI to accelerate reimbursement, reduce denials, and improve financial visibility and patient payment experiences.

📋 Description

• 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. • 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

🏖️ Benefits

• 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 our non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays • Flexible time off for our 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