RN Utilization Management Educator

Scope of work:

The Corewell Health Utilization Management Educator is responsible for facilitating the professional role development of Utilization Management teams functioning in the roles of change agent, mentor, facilitator of learning, leader, and partner for UM best practice. The UM Educator will work collaboratively with statewide Utilization Management Supervisors, Managers and Director to develop training curriculums and educational programs. This position requires experience developing/educating employees and knowledge of Utilization Management functions including but not limited to insurance authorization, utilization review, and clinical denials. Central to the UM Educator's role is to foster employee adoption of department and enterprise goals, policies, and procedures through development of meaningful education programs. Using tools of consulting, mentoring, coaching and interprofessional collaboration, the UM Nurse Educator facilitates the professional role development of UM nurses and other UM personnel along the continuum from novice to expert.

The UM Educator will work remotely and report directly to a regional Manager, Utilization Management.

• Responsible for the professional development of regional Clinical and Non-Clinical Utilization Management teams, including new hire orientation education. Additionally, monitors employee development and completion of educational requirements
• Collaborates with Utilization Management Supervisors, Managers, Director, and peer UM Nurse Educators across the statewide enterprise of Corewell Health to develop training curriculums and educational programs to optimize employee performance. Standard Work development is a key component of this role including writing of the components with leadership input, as well as ongoing maintenance/update of the electronic resource manual according to continual changes in industry regulations/payer requirement.
• Develops, coordinates, manages, facilitates, executes, and evaluates competency programs to ensure employee skills are aligned with role expectations
• Fosters interprofessional learning and enables effective collaboration to improve practice outcomes for the UM Department. Functions as a mentor, coach, and resource in the department of the UM roles as the empluee transitions throughout their career life cycle.
• Fosters adoption of statewide and regional department goals, policies and procedures, and standards of work by Utilization Management teams through deployment of meaningful education programs. Maintains awareness of regulatory requirements and department guidelines

Qualifications

• Required Bachelor's Degree or equivalent in Nursing

• 3 years of relevant experience Clinical experience related to area of focus; case management/utilization management experience Required
• Education and program development Preferred

• Registered Nurse (RN) - State of Michigan Upon Hire required

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

• Optional identity theft protection, home and auto insurance, pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Beaumont Service Center - 26901 Beaumont Blvd

Department Name

Utilization Management - CH East

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8:00 a.m. to 4:30 p.m.

Days Worked

Monday to Friday

Weekend Frequency

N/A

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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell 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, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.