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Coor-Utilization Mgmt - Full-time Days, (Henry Ford Macomb Hospital)
Requisition #: 94827
Status: Full-Time with Full-Time Benefits (40 Hours)
Business Unit: HF Macomb Clinton Twp
Department: Case Management - HFMH
Job Family: Quality/Utilization Review
Job Function: Nursing
Campus/Job Location: Henry Ford Macomb Medical Pavillion
Location (State/City): US-MI-Clinton Township
More information about this position
Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education. The system includes the 1,100-member Henry Ford Medical Group, six hospitals, Health Alliance Plan (a health insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory network and many other health-related entities throughout southeast Michigan, providing a full continuum of care. In 2013, Henry Ford provided $314 million in uncompensated care. The health system also is a major economic driver in Michigan and employs more than 23,000 employees. Henry Ford is a 2011 Malcolm Baldrige National Quality Award recipient. The health system is led by CEO Nancy Schlichting. To learn more, visit HenryFord.com
Under minimal supervision, reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered at Henry Ford Hospital. Combines clinical, business and regulatory knowledge and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided. Through continuous assessments, problem identification and education facilitates the quality of health care delivery in the most cost effective manner. Performs other related duties as required.
Registered Nurse with a valid, unrestricted State of Michigan License.
Minimum 3-5 years of clinical experience required.
Previous utilization management or case management experience required.
The ability to communicate with individuals from various socio-economic backgrounds regarding a variety of hospital-wide practices.
Knowledge of outside regulatory agencies that interface with the institution.
appeal writing experience preferred
experience with excel and data entry/analysis
Equal Employment Opportunity / Affirmative Action Employer
Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, national origin, sex, sexual orientation, age, disability, religion, weight/height, marital status, familial status, veteran status or any other characteristic protected by law..
About Henry Ford Health System
Henry Ford Health System, a Michigan not-for-profit corporation, is one of the nation's leading comprehensive, integrated health systems, providing acute, specialty, primary and preventive care services, backed by excellence in research and education. Founded in 1915 by auto pioneer Henry Ford, it is committed to improving the health and well-being of a diverse community.