Clinical Manager, Utilization Management (RN) —

Saginaw, MI Job Type:

Full-Time, Direct Hire Location:

Saginaw, MI (48601)

Schedule:

Monday-Friday, day shift | No weekends, holidays, or on-call A confidential acute care hospital in the Saginaw, MI area is hiring a Clinical Manager, Utilization Management to lead their UM department. This is a key leadership role overseeing utilization review operations, staff supervision, and physician advisor collaboration to ensure appropriate, compliant patient care across a 280-300 daily census. Job Summary The Clinical Manager, Utilization Management reports to the Director of Revenue Cycle and is responsible for the daily operations of the Utilization Management department, including staff supervision, compliance oversight, budget management, and cross-functional collaboration with Coding, Clinical Documentation Improvement, Case Management, and Billing/Denials teams. This leader also chairs the Utilization Committee and works directly with Physician Advisors on medical necessity and level-of-care decisions. Responsibilities Manage and supervise Utilization Review RN staff, a UM Tech, and UM Admin support Ensure department compliance with CMS Conditions of Participation and clinical review guidelines Own department budget preparation, payroll oversight, staff performance evaluations, and corrective action Partner with Physician Advisors on medical necessity determinations and level-of-care decisions Collaborate with Revenue Cycle, Coding/CDI, Case Management, and Billing/Denials leadership Chair the Utilization Committee and drive department strategy, workflow, and performance metrics Complete hospital New Employee Orientation and department onboarding, working alongside the outgoing team and Physician Advisor to transition responsibilities Qualifications Bachelor's Degree required Active Registered Nurse (RN) license in the State of Michigan required Experience in Utilization Management and/or Clinical Documentation Improvement required Minimum 3 years supervisory/management experience preferred Minimum 5 years of experience in an acute care patient setting preferred Experience with Epic, Interqual, and/or MCG preferred Benefits Comprehensive benefits package including medical/dental/vision coverage, retirement plan with employer match, paid time off, wellness programs, and tuition reimbursement. Apply Now #

DP Pay:

From $91,769.00 per year

Benefits:

401(k) Dental insurance Health insurance Health savings account Life insurance Professional development assistance Retirement plan Vision insurance

Education:

Bachelor's (Required)

Experience:

Supervisory /

Management:

3 years (Required) Ability to

Relocate:

Saginaw, MI 48605: Relocate before starting work (Required)

Work Location:

In person