Utilization Review Jobs in Flint, MI (NOW HIRING)

Hours Per Week: 40.00
Hours Per Day: 10.00
Days Per Week: 4.00
Shift Time: 4x10s 7:30am - 6pm with weekend rotation required.
Schedule Notes: 13 week contract REQUIRED: Minimum 5 years acute inpatient case management experience with experience in acute discharge planning, BSN, BLS certification through AHA, Previous experience using CarePort system. Candidates with previous experience charting in AllScripts, GEMS/Sunrise are preferred. Need candidates who are willing and able to be on the floor with patients and who can acclimate very quickly. Overtime is billed after 48 hours
Location: 1 Genesys Pkwy, Ascension Genesys Hospital, MIGRA1 GRAND BLANC, MI 48439
Note: The above mentioned rates are the strike rates due to the ongoing Grand Blanc strike. The rates would be reduced after the strike ends. Please contact to know more.
Position Summary: The RN Case Manager is responsible for supporting physicians and the interdisciplinary healthcare team in coordinating patient care to ensure high-quality outcomes, efficient resource utilization, and patient satisfaction. This position integrates discharge planning, utilization review, and care coordination to promote continuity of care across the healthcare continuum. The ideal candidate will possess strong critical thinking skills, extensive experience in acute inpatient case management, and the ability to acclimate quickly in a fast-paced hospital environment.
Key Responsibilities
• Coordinate and facilitate patient care activities from admission through discharge, ensuring efficient use of hospital resources.
• Manage a caseload of patients, providing clinical oversight and care coordination to meet individualized patient needs.
• Facilitate pre-certification and payor authorization processes for patient admissions, continued stays, and discharges.
• Collaborate with physicians, nursing staff, social workers, and payors to remove barriers to timely and effective care.
• Assist in discharge planning, ensuring appropriate post-hospital care, including home health, rehab, or skilled nursing placement.
• Serve as a resource for documentation support, helping ensure accurate reflection of patient acuity and service intensity.
• Participate in performance improvement initiatives and apply process improvement methodologies to enhance care outcomes.
• Educate patients and families on discharge instructions and care transitions.
• Maintain timely, accurate, and compliant documentation in CarePort, AllScripts, and GEMS/Sunrise systems.
• Function as an advocate for patients while balancing clinical and financial considerations.
• Collaborate with utilization review and finance departments to manage denials and optimize reimbursement.
Required Skills & Experience
• Minimum 5 years of acute inpatient case management experience with demonstrated proficiency in discharge planning.
• Strong clinical background with the ability to assess patient needs and coordinate multidisciplinary care.
• Experience using CarePort required; familiarity with AllScripts and GEMS/Sunrise preferred.
• Excellent interpersonal, communication, and negotiation skills.
• Analytical and data management skills with proficiency in PC applications.
• Strong organizational and time management abilities; able to manage multiple priorities with minimal supervision.
• Willingness and ability to work on the floor with patients and adapt quickly to changing conditions.
Preferred Experience
• Three (3) or more years of RN clinical experience in an acute care setting.
• Working knowledge of discharge planning, utilization management, performance improvement, and managed care reimbursement.
Education: Bachelor of Science in Nursing (BSN) – Required.
Required Certifications & Licensure
• Registered Nurse (RN) – Current and valid license to practice in the State of Michigan (in good standing).
• Basic Life Support (BLS) – Certification through the American Heart Association (AHA) – Required.