Working at Covenant HealthCare in Saginaw offers the opportunity to join a major regional, non-profit health system recognized as a top Michigan hospital, featuring strong community impact, professional growth, and comprehensive services!
- Job Description: Clinical Manager (Utilization Management Department)
- Covenant Medical Center Cooper - 700 Cooper Avenue, Saginaw Michigan 48602 - Level II
- Internal Pay Scale: Starting salary range $91,769 - commensurate with experience
Shift/Hours:
- Basic shift would be M-F 8a-4:30p, however flexibility to the team needs/workload would be expected.
- No floating to other facilities.
- This would be a 100% in-person position with occasional remote days.
Holiday/Weekend Requirement:
On Call Requirement:
Job Description:
- The Clinical Manager of the Utilization Management (UM) Department oversees the daily operations of the UM team.
- This position manages the Utilization Review Staff and ensures compliance with regulatory requirements related to the appropriateness and medical necessity of care provided.
- The Manager provides input to the Director of Revenue Cycle regarding daily strategic decisions that affect the UM department.
- This role maintains a commitment to excellent customer service consistent with the Vision, Mission, and Values of Covenant HealthCare and the commitment to Extraordinary Care for Every Generation.
Responsibilities:
- Lead and supervise Utilization Review staff and daily department operations.
- Ensure compliance with CMS, payer, and regulatory requirements.
- Monitor department performance, staffing, scheduling, and budget goals.
- Support medical necessity reviews, utilization management programs, and length-of-stay initiatives.
- Serve as a resource for Case Management, CDI, Coding, Billing, and Denials teams.
- Participate in strategic planning, process improvement, and departmental performance initiatives.
- Maintain payer knowledge and oversee Utilization Committee activities.
- Manage employee performance, payroll approval, and staff development.
Must Haves:
- License: Licensed RN in the state of Michigan
- Certification: None
- Experience: Minimum 3 years of supervisory/management experience preferred. Experience in Utilization Management and/or Clinical Documentation Improvement required. Candidate needs to of worked in an acute care setting as this is vital to the role.
- Education: Bachelor's Degree required
About the Role:
- Patient Population: Daily census runs 280-300
- Direct Reports: UM nurses, UM Tech, UM Admin + directly work with Physician advisors
- EMR/Systems Used: Epic, Interqual, MCG
Please apply today for immediate consideration!
#DP
Pay: From $91,769.00 per year
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
