Utilization Management Coordinator

3 hours ago


Pontiac, Michigan, United States Trinity Health Full time
Job Summary

We are seeking a highly skilled Utilization Management Coordinator to join our team at Trinity Health. As a key member of our healthcare team, you will be responsible for ensuring that all healthcare services provided are cost-effective and delivered in the most appropriate setting.

Key Responsibilities
  • Conduct thorough reviews of patient records to determine medical necessity and appropriateness of care.
  • Collaborate with healthcare teams to identify opportunities for cost savings and quality improvement.
  • Provide education and guidance to physicians and other healthcare professionals on third-party payer criteria and documentation requirements.
  • Act as liaison between third-party payers and hospital case management to secure authorization for hospital stays.
  • Participate in quality improvement initiatives to ensure optimal patient outcomes.
Requirements
  • Associate's degree in Nursing or Bachelor's degree in Nursing preferred.
  • Current RN licensure within the State of Michigan.
  • Certified Professional in Utilization Review/Management preferred.
  • Three years recent acute care utilization management experience.
What We Offer

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. We are committed to diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve.

We are an Equal Opportunity Employer and welcome applications from all qualified candidates. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.



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