Utilization Management Nurse - Clinical Manager

Covenant HealthCare; Saginaw (MI); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement plan with employer match

Paid time off

Wellness programs and mental health

Job summary

Covenant HealthCare in Saginaw, Michigan is hiring an RN Clinical Manager for the Utilization Management (UM) department. You will oversee day-to-day UM operations and supervise the Utilization Review staff to ensure medical necessity and regulatory compliance.

This role reports to the Director of Revenue Cycle and requires a BSN and Michigan RN licensure. Experience in UM and/or CDI is preferred, with at least 3 years of supervisory experience and 5 years in a patient care acute setting.

Qualifications

• BSN required.
• Licensed RN in Michigan.
• Experience in Utilization Management and/or CDI preferred.

Responsibilities

• Oversee day-to-day operations of the UM team.
• Supervise Utilization Review staff for eligibility and compliance.
• Provide input to Revenue Cycle leadership on daily strategic decisions.

Skills

Leadership

Team management

Education

BSN

Job description

Now Hiring - RN Clinical Manager - Utilization Management (UM)

Covenant Healthcare is HIRING in Saginaw, Michigan!!

Location: 1447 N. Harrison Street, Saginaw, MI 48602

Candidates must have the following:

• BSN
• Licensed RN in the State of Michigan required.
• Experience in Utilization Management and/or Clinical Documentation Improvement required.
• Minimum three (3) years of supervisory/management experience preferred.
• Minimum of five (5) years of experience in a patient care acute setting preferred.

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.

Shift/Hours:

40 hours/week

Covenant Health Employee Offerings:

• Comprehensive medical, dental, and vision coverage
• Retirement plans with employer match
• Paid time off to support work-life balance
• Employee wellness programs and mental health support
• Tuition reimbursement, university discounts, and professional development opportunities

About Covenant Health:

• The largest, comprehensive healthcare system in the Great Lakes Bay Region that delivers extraordinary care across generations and specialties.
• Some Programs & Services: high-risk obstetrics, pediatric intensive care, oncology, cardiology, orthopedic, and various robotic surgeries.