Job Information
Corewell Health RN Manager Utilization Management in Grand Rapids, Michigan
About Corewell Health
Our 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 Work
Manages and coordinates the clinical functions of the Utilization Management Department. Oversees the efficiency and effectiveness of the utilization management teams, made up of utilization management specialists and insurance coordinators. Oversees and supports clinical team functioning through Utilization Management supervisory staff. Addresses customer concerns/complaints related to clinical areas. Provides educational in-services to staff. Oversees performance evaluations for clinical staff. Collaborates with the leadership team to develop departmental goals and provide input related to the development and management of the budget. Develops policies and procedures in coordination with the leadership team to support Utilization and Care Management services in the provision of excellent clinical services.
Assumes day-to-day accountability for the delivery of quality services through consistent application of policies, procedures, protocols and standards.
Evaluates and makes recommendations regarding the training and continuing education needs of staff members that meets their needs, assures competence, and supports continuous learning. Provides direction and support to all staff to ensure effectiveness and efficiency.
Selects, trains, develops, and evaluates clinical employees. Maintains accountability for objective performance monitoring. Initiates personnel actions in accordance with departmental policies and organization philosophy, participating in disciplinary actions as needed, and in consultation with director, when warranted, terminating employees.
Manages the activities of professional staff who are engaged in performing utilization management services. Oversees the orientation, training and continuing education of employees supervised. Provides direction and support to assigned professional and support staff to ensure response to requests for services, information, records, and data on a timely basis. Monitors staff productivity and the efficiency and effectiveness of the work being done.
Manages the provision of services to all customers, including patients, physicians, hospital departments, and employees. Acts as a mentor/coach/role model/resource to employees and provides ongoing communication to the team on management issues and department goals. Establishes a positive work environment that supports open, direct, timely and respectful communication and mutual learning and growing. Researches and resolves problems.
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; OR Master's degree in Social Work or health care related field
5 years of relevant experience relevant clinical experience Required
1 year of relevant experience supervisory experience or equivalent combination of education, training, and years of experience Required
Experience working in an organization of size and complexity comparable to Corewell Health Required
Primary Location
SITE - 1300 Michigan St - Grand Rapids
Department Name
Care Management - Butterworth
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8:00 a.m. to 4:30 p.m.
Days Worked
Monday to Friday
Weekend Frequency
N/A
CURRENT 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.