Clinical Manager, Utilization Management (RN) — Acute Care Hospital
A confidential healthcare client in Saginaw, MI is hiring a Clinical Manager, Utilization Management to lead their UM/Utilization Review team. Reporting to the Director of Revenue Cycle, this leader will oversee UM Nurses, a UM Tech, and UM Admin staff, and work closely with Physician Advisors to ensure compliance and appropriate utilization across a 280-300 daily census.
What you'll do:
- Manage and supervise Utilization Review staff and daily UM operations
- Ensure compliance with CMS Conditions of Participation and clinical guidelines
- Own budget preparation, payroll oversight, performance evaluations, and corrective action
- Partner with Revenue Cycle leadership, Coding/CDI, Case Management, Physician Advisors, and Billing/Denials teams
- Lead the Utilization Committee and drive department strategy and metrics
What you need:
- Bachelor's Degree required
- Active RN license in the State of Michigan required
- Experience in Utilization Management and/or Clinical Documentation Improvement required
- Supervisory/management experience and acute care background strongly preferred
- Experience with Epic, Interqual, or MCG a plus
Schedule: Monday-Friday, day shift (salaried, no weekends, holidays, on-call, or float required)
Comprehensive benefits including medical/dental/vision, retirement match, PTO, wellness programs, and tuition reimbursement.
Apply today for immediate consideration!
#DP
Pay: From $91,769.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Relocation assistance
- Tuition reimbursement
- Vision insurance
Education:
Experience:
- Utilization management: 3 years (Required)
- Clinical documentation improvement: 3 years (Required)
- Acute care: 2 years (Required)
Work Location: In person
