Facility: Priority Health - GRAND RAPIDS, MI
Department: Ph-Inpatient Util Mgmt
Category: Health Plan
Classification: Full-time with Benefits (A1)
Effectively leads and motivates the Post-Acute Care Utilization Management team to ensure the goals and standards of the department are met. This position is responsible for managing the day to day operations of team performing utilization review for skilled nursing and subacute rehab services. The Manager will oversee the planning and implementation of utilization management projects, initiatives, work flows, and processes to enhance outcomes. The main functions include management of a multidisciplinary clinical team, ensuring compliance with regulations, monitoring facility performance and partnering with facilties to improve care outcomes and launch quality programs.
Basic Qualifications:
Education - Bachelor's Degree in in Nursing or related field (or equivalent education and experience)
Experience - 3 years of experience typically gained through skills/knowledge/abilities in Leadership 5 years of experience typically gained through skills/knowledge/abilities in Clinical experience in acute care or office setting
Licenses -
Registered Nurse (RN) Upon Hire
Preferred Qualifications:
Experience - 3 years of experience typically gained through skills/knowledge/abilities in Managed care experience Knowledgeable of compliance and regulations as it relates to medical operations
Spectrum 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, sexual orientation, veteran status, or any other legally protected category.