The Clinical Nursing Director for Utilization Review of the Division of Nursing Administration, Department of Care Management, will plan and manage the staffing and administration of a nursing unit or floor. Supervises the Utilization Staff and processes in Care Management. The primary duty of employees is management of a customarily recognized department or subdivision, including the supervision of three or more full-time equivalent employees every week. This role assures implementation of patient care processes and quality assurance standards; plans, organizes, and evaluates clinical practice and educational activities. Participates in planning, development and implementation of unit policies, goals and objectives and standard of nursing practice. Counsel and evaluate the performance and clinical practice of the nursing, technical, and clerical staff. Management duties include interviewing, selecting and training of employees; setting and adjusting their rates of pay and hours of work; planning and directing their work; appraising their productivity and efficiency for the purpose of recommending promotions or other changes in their status; handling their complaints and grievances and disciplining them when necessary. This includes staff development programs and unit orientation to ensure compliance with practice standards. Identify and resolve unit operational problems. Represent the unit on assigned clinical area and Hospital committees. Management responsibilities include the authority to hire, fire, or promote assigned employees or make recommendations that are given particular weight. Employees have impact on budgeting, controlling costs, planning, scheduling, and procedural change. Maintain compliance with Federal and State regulations regarding affirmative action, safety and patient care. Actively collaborate with the Sr. Director of Care Management and Divisional leadership in the development of annual budgets and activity forecasts; manages and provides variance reporting of activity, payroll, commodity and capital budgets; participates in new program development and implementation; and works closely with the Medical Director and Sr. Director of Care Management to create and support an environment where cutting edge and innovative care is provided Under FLSA, this is the exempt job classification for this title. Incumbents in this position must meet the full criteria for exempt status: salary level, salary basis, and duties tests.
• Develop and implement unit goals and objectives which include the establishment of standards of practice in patient care consistent with national professional and regulatory guidelines.
• Integrate unit goals and objectives with Nursing goals and objectives. Advise and assist with the establishment of priorities and institutional program development.
• Work closely with medical staff and other disciplines for the successful implementation of patient, unit and institutional objectives. Assist in the resolution of interdisciplinary operating problems.
• Supervise operations of the unit. Establish minimum/maximum staffing patterns to insure quality patient care. Initiate and implement a staffing schedule which is consistent with care requirements and responds to varying patient activity and patient mix.
• Identify and recommend specific staffing needs and position qualifications consistent with the respective unit objectives and patient case mix.
• Interview and select qualified personnel.
• Evaluate performance of nursing staff responsible for patient care unit. Make recommendations for merit awards and personnel classification changes. Counsel and discipline nursing staff to enable achievement of unit and institutional objectives, particularly related to high quality patient care.
• Interpret and implement University and hospital personnel policies and programs and ensure their uniform and correct application.
• Project and monitor personnel budget for patient care unit. Provide information regarding budget variances to the Sr. Director of Care Management and Divisional leadership.
• Collaborate and coordinate with other disciplines to plan, evaluate, and implement the commodity budget for the clinical care unit(s).
• Initiate and implement in-service guidelines for unit level orientation and staff development. Encourage and provide opportunities for continuing education of the nursing, technical and clerical staff.
• Initiate, plan, analyze, and participate in Nursing and ancillary staff development programs and workshops.
• Participate in concurrent and retrospective evaluation of patient care consistent with the hospital quality improvement programs. Through this review process, evaluate and recommend changes and improvements in areas affecting the quality and safety of patient care.
• Establish guidelines with the nursing faculty, which support the institutional goal of providing the primary clinical environment for nursing students. Facilitate, coordinate, and monitor the clinical experience of nursing and other students.
• Initiate and cooperate in the applied research in health care in keeping with the institutional objectives of maintaining prominence in developing new modes of clinical practice.
• Formulate professional goals and prepare written evaluation for appropriate staff.
• Provide coordination between management and patient care activities that are consistent with the institutional objectives for achieving high standards of patient care, as well as other institutional goals and objectives.
• Provide essential coordination between patient care units, recovery area, Anesthesia and inpatient units for safe patient care and efficient throughput that is consistent with unit institutional goals and objectives.
The position supervises the clinical staff including nurses, technicians, clerical and administrative support staff within the Utilization Review Unit, Care Management.
Nursing Specific Info
If you have questions regarding this posting or would like assistance with nursing opportunities please contact Nurse Recruitment at (734) 936-5183.
Current licensure as a Registered Nurse in the state of Michigan.
Required Educational Requirement:
- Master’s degree in Nursing or Health Care Administration, Public Health, Business or related field (a Juris Doctor degree may be considered)
- If Master’s degree is not in Nursing, a Bachelor’s degree in Nursing is required.
- Minimum of 5 years of RN experience with demonstration of progressive clinical competence in Utilization Review Care Management.
- Demonstrated leadership and management skills including personnel management and the ability to perform as a role model for nursing, technical and clerical staff.
- Demonstrated excellent written and verbal communication skills
- Demonstrated ability to collaborate in a manner that fosters teambuilding and to provide visionary direction for team members.
- Demonstrated ability to work effectively with administrators, physicians, peers, and subordinates. Experience in collaboration with revenue cycle, coding, Physician Advisors and finance required.
NOTE: Required qualifications must be met by the candidate in order to be interviewed and considered for the position.
RESUME REQUIRED: (for both internal & external applicants): You must attach a complete and accurate resume along with a cover letter to be fully considered for this position.
- Experience in managing large complex procedural environments and personnel and commodity budgets
- Knowledge and experience in creating, maintaining and managing staffing systems, schedules and models to deliver patient care with the right skill set and mix, at the right time in the right setting.
- Knowledge and experience in the application of LEAN Management principles.
- Experience in Patient and Family Centered Care
- Professional certification in Care Management (CCM, ACM, CMAC) highly preferred.
- Hours: Generally, 40 hours/week Monday to Friday. Some evenings and weekends may be necessary
- Shift: Shift and hours will vary based on department needs
- Location: Care Management
The Care Management Program adds value to the care of our patients and families through improved coordination, communication and appropriate utilization of healthcare resources. We do this by adhering to the following principles:
- Facilitate access to the right level of care, at the right time, in the appropriate setting
- Exhibit exceptional service and communication with patients and patient care team members
- Engage patients and families in their care, particularly in transitions of care
- Collaborate and communicate across disciplines/providers
- Practice evidence based and data driven clinical decision making
- Measure and report program metrics in a timely, visible manner to support operational goals
- Incorporate utilization management strategy and goals into the daily work of the interdisciplinary
- patient care team
- Ensure compliance with regulatory requirements
- Support processes that ensure revenue integrity for the institution
- Communicate business requirements to patients in a timely way to facilitate informed decision making
Our goals are to provide
- Improve patient satisfaction with discharge process
- Reduce length of stay by reducing delays and barriers to timely care
- Reduce unnecessary admissions and readmissions by improving the transition process
- Ensure compliance with regulatory, financial and utilization review requirements
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act.
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.
Michigan Medicine seeks to recruit and retain a diverse workforce as a reflection of our commitment to serve the diverse people of Michigan and to maintain the excellence of the University. We welcome applications from anyone who would bring additional dimensions to the University’s research, teaching, and clinical mission, including women, members of minority groups, protected veterans, and individuals with disabilities. The Department of Nursing, like the University of Michigan as a whole, is committed to a policy of nondiscrimination and equal opportunity for all persons and will not discriminate against any individual because of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, height, weight, or veteran status.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.