What are the responsibilities and job description for the Utilization Management Educator position at Beaumont Health?
GENERAL SUMMARY:
The Utilization Management (UM) Educator is responsible for facilitating the professional role development of Clinical and Non-Clinical Utilization Management teams. The UM Educator will work collaboratively with regional Clinical/ Non-Clinical Utilization Management Supervisors and Managers to develop training curriculums and educational programs. This position requires experience developing/ educating employees and knowledge of Utilization Management functions including but not limited to insurance authorization, utilization review, and clinical denials. Central to the UM Educator’s role is to foster employee adoption of department goals, policies, and procedures through development of meaningful education programs.
The UM Educator will work remotely and report directly to the regional Clinical and/or Non-Clinical Utilization Management Managers.
AREAS OF RESPONSIBILITY:
1. Professional development of regional Clinical and Non-Clinical Utilization Management teams
2. Fostering employee adoption of department goals, policies, and procedures
ESSENTIAL DUTIES:
1. Responsible for the professional development of regional Clinical and Non-Clinical Utilization Management teams, including new hire orientation education. Additionally, monitors employee development and completion of education requirements.
2. Collaborates with regional Clinical/ Non-Clinical Utilization Management Supervisors and Managers to develop training curriculums and educational programs that address deficits in employee performance. Designs and executes competency testing to ensure employee skills are aligned with role expectations.
3. Responsible for evaluating the efficiency of existing policies and interpreting new policies to identify improvement opportunities. A key focus of evaluating policies is to ensure synergies between clinical and clerical Utilization Management processes.
4. Fosters adoption of department goals, policies, and procedures by Utilization Management teams through deployment of meaningful education programs. Maintains awareness of regulatory requirements and department guidelines.
This document represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described.
STANDARD REQUIREMENTS:
1. Supports the Mission, Value and Vision of Corewell Health. Demonstrates personal commitment through active involvement in the performance improvement process.
2. Supports the Patient and Family-Centered Care (PFCC) model:
â— Treats individuals with dignity and respect
â— Shares complete and unbiased information with patients and their families
â— Encourages and supports patient and family participation in their care
â— Partners and collaborates with patients, families, and team members to ensure an excellent and positive patient experience.
3. Supports and contributes towards the Corewell Health culture:
â— Brings best self to work each day
â— Is highly engaged
â— Reflects a team-oriented approach
â— Strives for excellence
â— Treats patients, families, and co-workers with compassionate, extraordinary care every day
4. Exhibits excellent customer service skills and behaviors toward internal and external customers and co-workers. Promotes positive public relations with patients/residents, family members, guests, and others.
5. Supports and adheres to all Corewell Health’s customer service, service excellence, and performance standards. Supports and participates with all required compliance standards that may be department specific and/or identified by the organizations including in-service training, acceptable attendance, uniform and dress code.
6. Adheres to HIPAA requirements and maintains confidentiality of all data, including patient/resident, employee and operations information.
7. Supports and participates in a collaborative team-oriented environment – cooperates and works together with all co-workers, plans and completes job duties, uses appropriate communications in sensitive and emotional situations and follows up as appropriate regarding reported complaints, problems and concerns.
8. Supports, cooperates with and demonstrates safe work practices and attitudes, follows safety rules – including universal precautions - reports and prevents/corrects unsafe conditions and behaviors, and participates in organizational and departmental safety programs.
9. Completes all required compliance standards that may be department specific and/or identified by the organization.
10. Maintains current licensure, registration and/or certification, as applicable, at all times.
KEY LEADERSHIP COMPETENCIES:
1. Builds Trust
2. Creates and Communicates Clarity
3. Works Collaboratively and Fosters Teamwork
4. Builds a Cohesive Team
5. Utilizes Strategic Judgment
6. Cultivates a Service-Oriented Culture
7. Creates and Communicates Vision and Strategy
8. Leads Change and Innovation
STANDARD QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
A. Education / Training:
â— Associate’s Degree in Nursing; OR Bachelor’s Degree in business, healthcare, or related field (Required)
B. Work Experience:
â— Three years minimum experience educating or developing employees in a healthcare setting
â— Preferably has relevant clinical experience or experience working in a Utilization Management, Patient Access, or Patient Financial Services department
C. Certification, Licensure, Registration:
â— Registered Nurse (Preferred)
Beaumont offers a comprehensive benefits package to meet your financial, health and life-work balance goals.
- NEW On-demand pay program – powered by Payactiv
- Generous paid time off, holidays and flexible scheduling
- Our employees receive special discounts on a wide range of products and services
- Exceptional health, dental, vision and prescription drug insurance plans
- Relocation assistance
- Generous retirement savings, disability insurance, identify theft protection and even home and auto insurance
Our diverse and talented teams of professionals and clinicians don’t just share in the success of our system; they make it possible. Driven by our shared commitment to making our communities healthier and stronger, we are leading the way in health care innovation with relentless ambition and a belief that anything is possible when we work together.
This is where extraordinary begins. Find out where it can take you and your career. Apply Now!
Beaumont 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.
Salary : $80,000 - $101,000