About Corewell HealthOur new name signals our bold commitment to health and wellness. At our core, we are here to help people be well so they can live their healthiest life possible. Through health care and health coverage, we create more value. Through compassion, collaboration, clarity, curiosity and courage, we make anything and everything possible. Through our people, we care for the whole person with respect, dignity and love. Everyone deserves opportunities and resources for better health. Everyone deserves our relentless pursuit to innovate and always do better. Everyone deserves to have a community be a great place to live, work, learn and play. We believe health and well-being should be within reach for all. We believe the system to support the entire health and wellness journey starts with prevention. We believe that together we will make a difference. Together, we are here to make health better for everyone. Together, we are Corewell Health.Scope of WorkThe Clinical Utilization Management (UM) Manager is responsible for managing and coordinating the clinical functions of the Utilization Management Department, which includes but is not limited to authorization, utilization review, clinical denials, and denial prevention strategies. The Clinical UM Manager will provide regional oversight of Clinical Utilization Management supervisory staff and Clinical Utilization Management teams, comprised of UM Coordinators and Analysts. This position requires clinical experience and experience managing staff, including performance monitoring, education and process improvement. Central to the Clinical UM Manager's role is to develop department goals, policies, and procedures in collaboration with leadership teams to support Utilization services in the provision of excellent clinical services.The Clinical UM Manager will work remotely and report directly to the Regional Senior Director of Utilization Management.
Responsible for providing regional oversight of Clinical Utilization Management supervisory staff and Utilization Management teams, comprised of UM Coordinators and Analysts. Ensures adequate staffing is in place to support timely and effective delivery of UM services.
Collaborates with the Regional Senior Director of Utilization Management to develop and implement department goals, policies, and procedures. Responsible for evaluating the efficiency of existing processes to identify process improvement opportunities. Additionally, provides input around development and management of department budgets.
Responsible for ensuring services delivered by staff are in accordance with regulatory requirements and department policies, procedures, protocols, and standards. Ongoing communication should be provided to teams around management issues and department goals.
Responsible for monitoring and evaluating clinical employee performance to identify opportunities for development and targeted training for staff. Initiates personnel actions in accordance with departmental policies and organization philosophy, participating in disciplinary actions as needed, and in consultation with leadership when warranted, terminating employees.
Responsible for managing activities of professional staff engaged in performing UM services. Oversees the orientation, training, and development of employees supervised. Provides direction and support to staff to ensure timely completion of requests for services, information, records, and data. Monitors staff productivity and effectiveness of work performed.
How we will care for you, while you care for our patients
Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here (https://careers.corewellhealth.org/us/en/benefits-new) .
On-demand pay program powered by Payactive
Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
Optional identity theft protection, home and auto insurance, pet insurance
Traditional and Roth retirement options with service contribution and match savings
Qualifications
Required Bachelor's Degree in Nursing
5 years of relevant experience relevant clinical experience in acute care setting Required
2 years of relevant experience supervisory experience Required
Experience working in an organization of size and complexity comparable to Corewell Health Required
Registered Nurse (RN) State of Michigan
Primary LocationSITE - Beaumont Service Center - 26901 Beaumont BlvdDepartment NameUtilization Management - CH EastEmployment TypeFull timeShiftDay (United States of America)Weekly Scheduled Hours40Hours of Work8:00 a.m. to 4:30 p.m.Days WorkedMonday to FridayWeekend FrequencyN/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.You may request assistance in completing the application process by calling 616.486.7447.People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.
