Spectrum Health Clinical Program Specialist 2 (Priority Health) in GRAND RAPIDS, Michigan

Position Summary style="margin: 0in 0in 0pt;"spanspan style="color: #333333; font-family: 'Arial','sans-serif'; font-size: 10pt;"Responsibility for coordinating and applying processes and services in Priority Health Medical Department and/or managing performance provided by vendors and disciplines within and outside the Priority Health. Understanding and working closely with Priority Health Coding Department assisting in appropriate mapping and configuration of clinical authorizations and medical policies. Exercises independent judgment in the clinical assessment, diagnosis initiation of selected protocolsrocedures. Provides educational support for health team members, the community and coordinates evaluation practices to measure outcomes of programs in close collaboration with Medical Operations Department and other Priority Health departments. /span/span Basic Qualifications: Education - Bachelor's Degree in related field Experience - 2 years of experience typically gained through skills/knowledge/abilities in related experience Licenses - Registered Nurse (RN) Preferred Qualifications: Education - Bachelor's Degree in related field ICD10 Knowledge with billing/coding experience Authorization and Utilization Management Experience