DetroitRecruiter
the smart solution for Detroit jobs

RN Director of Utilization Management

Company: Ascension (System Office)
Location: Sterling Heights
Posted on: June 14, 2018

Job Description:

Job ID: 257068 RN Director of Utilization Management Sterling Heights, Michigan Regular / Day Additional Job Information Title:--RN Director of Utilization Management City, State:-- Sterling Heights, MI Location:-- US Health Holdings/ABS Department:---- ACO Care Management 001 Additional Job Details:----FT, Days About Us Ascension is a faith-based healthcare organization dedicated to transformation through innovation across the continuum of care. As the largest non-profit health system in the U.S. and the world---s largest Catholic health system, Ascension is committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. In FY2017, Ascension provided more than $1.8 billion in care of persons living in poverty and other community benefit programs. Ascension includes approximately 165,000 associates and 34,000 aligned providers. Ascension---s Healthcare Division operates more than 2,600 sites of care --- including 153 hospitals and more than 50 senior living facilities --- in 22 states and the District of Columbia, while its Solutions Division provides a variety of services and solutions including physician practice management, venture capital investing, investment management, biomedical engineering, facilities management, clinical care management, information services, risk management, and contracting through Ascension---s own group purchasing organization. Job Description Job Summary: The RN Director of Utilization Management provides strategic direction and oversight of the day-to-day operations of utilization management function within the insurance plan. Responsibilities:

  • Ensures integration of utilization management functions with network strategy and claims processing.
  • Oversees work with provider relations on resolving issues.
  • Manages activities related to staffing, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.
  • Develops systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to implement and manage comprehensive outpatient and inpatient utilization management programs.
  • Oversees implementation and maintenance of prior authorization codes for all clients. Qualifications Education:
    • Bachelor's degree in nursing, or combination of diploma from an accredited school/college of nursing and related experience required.
    • Master's degree in a related field, or combination of Bachelor's degree and related experience preferred. Work Experience:
      • 5 Years Required Technical Experience.
      • 10 Years Preferred Technical Experience.
      • 2 Years Required Leadership/Mgmt Experience.
      • 5 Years Preferred Leadership/Mgmt Experience. Equal Employment Opportunity Ascension Health is an EEO/AA employer: M/F/Disabled/Vet. For further information regarding your EEO rights, click on the following link to the ---EEO is the Law--- poster: -- Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants. E-Verify Statement Ascension Health participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. Share: -->

        Keywords: Ascension (System Office), Detroit, RN Director of Utilization Management, Healthcare, Sterling Heights, Michigan

        Click here to apply!

        Didn't find what you're looking for? Search again!


        I'm looking for
        in category
        within


Other Healthcare Jobs


Locum Tenens Hospitalist Nurse Practitioner (Dearborn Heights,MI)
Description: Locum Tenens Hospitalist Nurse Practitioner Dearborn Heights,MI A hospital in Michigan is currently
Company: LocumTenens.com
Location: Dearborn Heights
Posted on: 06/19/2018

RN Registered Nurse - Orthopedics Unit
Description: RN Registered Nurse - Orthopedics Unit Job ID: 258252 RN Registered Nurse - Orthopedics Unit Novi, Michigan Regular Additional Job Information Title: Registered Nurse City, State: Novi,MI Location: Providence (more...)
Company: St. John Providence, MI
Location: Novi
Posted on: 06/19/2018

RN Registered Nurse - Cardiac Intermediate Care Unit
Description: Job ID: 253795 RN Registered Nurse - Cardiac Intermediate Care Unit Detroit, Michigan Regular Additional Job Information Title:--Registered Nurse City, State:-- Detroit, MI Location:-- St John Hospital (more...)
Company: St. John Providence, MI
Location: Detroit
Posted on: 06/19/2018


Physical Therapist - Michigan 13 wk contract
Description: Cross Country Allied has your next contract waiting for youin Michigan.Find rewarding professional opportunities and endless excitement with an allied travel career. From the Hollywood Hills to Broadway, (more...)
Company: Cross Country TravCorps
Location: Detroit
Posted on: 06/19/2018

Social Worker
Description: Social Worker For the vast majority of social workers, their career choice is based on one simple ideal: a deep desire to help others help themselves. Serving as a social worker with the U.S. Army provides (more...)
Company: United States Army
Location: Southfield
Posted on: 06/19/2018

Locum Tenens Psychiatrist (Stow,OH)
Description: Locum Tenens Psychiatrist Stow,OH Part-time locum tenens psychiatrist needed
Company: LocumTenens.com
Location: Stow
Posted on: 06/19/2018

Vascular Surgery
Description: Surgery-Vascular opening in Detroit, Michigan. This and other physician jobs brought to you by DocCafe.com Opportunity exists for a dynamic Vascular Surgeon to join a surgery group in Michigan. Candidate (more...)
Company: CompHealth
Location: Detroit
Posted on: 06/19/2018

Locum Tenens Urgent Care Physician in Ohio (Westlake,OH)
Description: Locum Tenens Urgent Care Physician in Ohio Westlake,OH Urgent Care physician job in Ohio : We have a new opportunity for an urgent care physician to practice in northeastern
Company: Global Medical Staffing
Location: Westlake
Posted on: 06/19/2018

Registered Nurse (RN) - 13 wk Ohio contract
Description: Cross Country TravCorps has your next Travel Nurse contract waiting for you in Ohio.Great positions are available for experienced ER,
Company: cross country travcorps
Location: Columbia Station
Posted on: 06/19/2018

Travel RN-Dialysis Nurse - Travel Dialysis Chronic Nurse Nee
Description: A chronic dialysis program in the beautiful state of Michigan is in need of an experienced dialysis nurse. Applicants should have a MI License and at least one year of dialysis experience for this thirteen (more...)
Company: Foundation Medical Staffing
Location: Livonia
Posted on: 06/19/2018

Log In or Create An Account

Username:
Password:
 

Forgot password?


Find us on Facebook

Find us on LinkedIn

Get the latest Michigan jobs by following @recnetMI on Twitter!

Detroit RSS job feeds