Nursing Utilization Review Jobs in Rochester, MI

The Length of Stay (LOS) Administrative Lead is responsible for the daytoday operational leadership, coordination, and execution of regional and / or hospital level LOS reduction efforts. This role serves as the central integrator across LOS Physician Leads, Patient Flow Coordinators, Care Management, Nursing, Utilization Management, and operational leaders to ensure reliable execution of standard work, effective escalation, and measurable improvement in LOS performance.
Acting as the primary administrative and operational owner for LOS initiatives, working in partnership with the LOS physician lead, the LOS Administrative Lead ensures consistent implementation of progression rounds, escalation pathways, and complex case review processes. The role partners closely with LOS Physician Leads to translate clinical direction into operational action and supports Progression Expeditors by providing structure, prioritization, and accountability for barrier resolution and care progression efforts.
The LOS Administrative Lead oversees LOS escalation processes, supports complex and prolongedstay reviews, and ensures issues are surfaced, prioritized, and resolved through the appropriate clinical and operational channels. This role also coordinates data review, performance monitoring, and standardwork adherence to identify trends, recurring barriers, and opportunities for hospitallevel improvement.
In addition, the LOS Administrative Lead plays a key role in developing, maintaining, and refining LOS workflows, tools, and serves as a liaison between frontline teams, hospital leadership, and regionlevel forums. Success in this role requires strong operational judgment, the ability to influence without direct authority, and the skill to align multidisciplinary stakeholders around shared LOS goals.
Performance is measured through sustained improvement in observedtoexpected LOS, reduction in avoidable days and opportunity days, effective escalation and resolution of barriers, consistent execution of progression rounds, and strong collaboration between physician, nursing, and operations teams in advancing patient care progression and reducing LOS.

• LOS Operational Leadership & Program Ownership
  • Serve as the day to day operational lead for hospital and system length of stay (LOS) improvement efforts
  • Partner closely with LOS Physician Leads to translate clinical direction into operational execution
  • Provide oversight and coordination for LOS related initiatives across nursing, care management, utilization management, and ancillary services
  • Ensure alignment between frontline execution, physician leadership, and system level LOS priorities
• Progression Rounds & Standard Work Oversight
  • Ensure consistent implementation and reliability of multidisciplinary progression rounds in accordance with system standard work
  • Uses progression rounds audit findings to drive accountability, coaching, and continuous improvement
  • Identify gaps in execution and partner with leaders to address variation in practice across units or sites
• Escalation & Complex Case Management
  • Own the LOS escalation process, including maintenance of escalation pathways, tools, and education
  • Ensure timely identification, prioritization, escalation, and resolution of LOS driving barriers
  • Lead or support complex and prolonged stay patient review processes to remove clinical, operational, or disposition barriers
  • Coordinate escalation across physicians, care management, operational leaders, patient flow coordinators and system forums as appropriate
• Data Review, Performance Monitoring & Accountability
  • Partner with analytics and operational teams to review LOS related data, trends, and performance metrics
  • Use data to identify high impact opportunities, recurring barriers, and units or populations requiring focused intervention
  • Track action plans, escalation outcomes, and improvement progress to ensure sustained LOS performance
• Cross Functional Collaboration & Communication
  • Facilitate collaboration across physicians, nursing, care management, utilization management, therapy, and operational leaders
  • Serve as a key liaison between frontline teams, hospital leadership, and system level LOS teams
  • Communicate expectations, progress, and barriers clearly to stakeholders at multiple levels of the organization
• Continuous Improvement & Program Development
  • Identify systemic LOS drivers and contribute to development of standardized workflows, tools, and best practices
  • Support education and change management efforts related to LOS, progression rounds, and escalation processes
  • Partner with operational transformation and performance improvement teams to advance LOS initiatives

Required

• Bachelor's Degree in healthcare or related field such as nursing, healthcare administration, health sciences, business administration, public health, or social work
• 5 years of relevant experience in healthcare operations, clinical operations, care management, utilization management, performance improvement or related healthcare leadership roles
• Capable of building relationships quickly and authentically
• Must hold at least one license from the list below upon hire:
  • LIC-Registered Nurse (RN)
  • LIC-Clinical Pharmacist
  • LIC-Physical Therapist
  • LIC-Occupational Therapist
  • LIC-Medical Social Worker (MSW-Medical)

Preferred

• Master's Degree in Healthcare Administration (MHA), Nursing (MSN), Business Administration (MBA), or Public Health (MPH)

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

• 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
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

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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.