C

RN Medical Utilization Management Educator

icon briefcase Job Type : Full Time

Number of Applicants

 : 

000+

Click to reveal the number of candidates who applied for this job.
icon loader
Apply Now
icon loader Apply Now

Let AI Supercharge Your Job Hunt!

JobCopilot scans 500,000+ company career sites daily to find jobs for you

Never miss an opportunity Save hours by auto-filling applications forms Land more interviews with tailored applications
happy man
thunder iconActivate JobCopilot

Job Description - RN Medical Utilization Management Educator

Registered Nurse

Looking for Utilization Management AND Education experience.

Scope of work:
In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral Health, Care Management, and Utilization Management departments. Stakeholders include staff, physicians, department leadership, and third-party vendors. Uses specific age and culture-related physical, intellectual, psychological, and development attributes in the educational plans for staff. Reports to either a Director of Behavioral Health, Care Management, or Utilization Management with matrix reporting to other areas in Medical Management.
  • Develops/implements the educational plan for Behavioral Health, Care Management, and Utilization Management.
    ·Develops/implements orientation of new staff which is comprehensive and individualized with one-on-one training for three or more weeks.
    ·Rounding and telephonic support of staff education needs and problem solving.
    ·Ongoing education based on analysis of outcomes from external audits.
    ·Education and support for implementation and ongoing use of new electronic medical record system and supplemental ancillary computer systems.
    ·Collaborate with educators to Provide education and support as needed.
  • Conducts department-specific assessment for educational needs related to Compliance Monitoring and Education.
    ·Monthly auditing of Compliance Risk areas and identification of staff education and documentation needs to ensure compliance
    ·Annual education on InterQual ® criteria changes with annual Interrater Reliability Assessment.
    ·Analyze and evaluate the effectiveness of all educational activities.
  • Conducts educational workshops to medical management and related audiences as requested.
    ·Education of changes and payor requirements to targeted Physician groups.
  • Develops informational materials and/or other media to be distributed to internal/external customers.
    · Internal/external orientation material.
    · Maintains and updates repositories of educational content needed for staff orientation, day-to-day operations, and continuing education on Sharepoint sites.
    · Develops annual education plan to ensure Care and Utilization management staff have access to current best practice and relevant updates.
    · Monthly auditing for specific areas of focus as directed by leadership, to ensure adherence to clinical best practice.
     
  • Department Liaison for external audits.
    ·Coordinates and facilitates with other departments to ensure readiness for audits
    ·Analyze audit recommendations
    ·Reporting outcomes and development/implementation of staff education as needed.
    ·Assists with project and program improvement efforts
Qualifications
  • Required Bachelor's Degree
  • Preferred Master's Degree
  • Utilization Management experience highly preferred.
  • Education and/or training experience highly preferred
  • 3 years of relevant experience Must have 3 to 5 years' experience in Care Management, or Utilization Management. Required
  • 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 - Priority Health - 1231 E Beltline Ave NE - Grand Rapids

    Department Name

    Utilization Management Operations - PH Managed Benefits

    Employment Type

    Full time

    Shift

    Day (United States of America)

    Weekly Scheduled Hours

    40

    Hours of Work

    8 a.m. to 5 p.m.

    Days Worked

    Monday to Friday

    Weekend Frequency

    N/A

    CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

    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.

    Original job RN Medical Utilization Management Educator posted on GrabJobs ©. To flag any issues with this job please use the Report Job button on GrabJobs.
    Apply Now
    Share Job
    Share Job

    Auto-Apply to RN Medical Utilization Management Educator Jobs with your AI JobCopilot

    thunder icon Auto-Apply with AI

    Similar RN Medical Utilization Management Educator Jobs in the US

    GrabJobs is the no1 job portal in the US, connecting you to thousands of jobs fast! Find the best jobs in the US, apply in 1 click and get a job today!

    Mobile Apps

    Copyright © 2026 Grabjobs Pte.Ltd. All Rights Reserved.