Supervisor - Utilization Review

General Summary

The Supervisor of Utilization Management has an important role in a high-profile group tasked with implementing system-wide improvements and operational processes to ensure optimal and compliant utilization review strategies. Under minimal supervision from the Manager the Supervisor is responsible for monitoring productivity and ensuring the day-to‑day tasks are completed in a timely fashion. Responsibilities include personnel management, communication with key stakeholders (both within the centralized unit and local sites), dashboard and reporting development, and working closely with leadership to drive progress toward system goals.

This position requires strong interpersonal and communication skills and well‑developed analytic and organizational skills and must be able to work effectively with leaders at all levels of the organization. Flexibility, innovation, and creativity are necessary characteristics of the successful candidate. Expectation is to learn and apply new continuous improvement methodologies, and to spread successful innovation throughout the institution.

• Registered Nurse with valid unrestricted Michigan license.
• Bachelor’s Degree in Nursing or Associate Degree in Nursing plus four (4) years’ experience in a healthcare related field.
• Four or more years of experience in a hospital, health insurance, or other health care agency setting required, with at least one year of experience in project management, revenue cycle, and/or clinical operations preferred.
• Strong leadership/mentoring skills applicable to both inter‑departmental staff and multi‑disciplinary teams.
• Knowledge of Medicare, Medicaid, Blue Cross and other third‑party payers billing and reimbursement regulations/policies, preferred.
• Demonstrates fluency in healthcare financial management and revenue cycle management best practices.
• Exceptional detail orientation and project management skills; ability to estimate time frames and meet projected deadlines; ability to manage large, complex, simultaneous assignments with potentially conflicting priorities and deadlines.
• Excellent communicator – able to express complex ideas clearly and effectively to a varied audience, including the ability to teach complex technical/analytical concepts to System leadership, management, and staff.
• Foundational knowledge of analytical/technical, facilitative, and process improvement knowledge.

Registered Nurse with a valid, unrestricted State of Michigan License.

• Organization:
  Corporate Services
• Department:
  Central Utilization Mgt
• Shift: Day Job
• Union Code:
  Not Applicable