Behavioral Health Utilization Case Manager

Havenwyck Hospital; Auburn Hills (MI); On-site; USD 60,000 - 90,000; Full time

Job summary

Havenwyck Hospital in Auburn Hills, Michigan seeks an Utilization Management Case Manager to organize and conduct medical necessity reviews and discharge planning. Responsibilities include liaison with the Treatment Team and external payers to optimize resource use and ensure appropriate care levels.

The role requires a Bachelor’s degree in social work, psychology, counseling, or nursing, and relevant licensure. Two years of post-graduate psychiatric experience is preferred.

Qualifications

• Bachelor degree in social work, psychology, counseling or nursing required.
• Limited or fully licensed (LBSW, RN, LLMSW, LLP, TLLP, LPC, LMFT, etc.).
• Minimum of 2 years post-graduate psychiatric/substance abuse experience.
• Familiarity with hospital utilization review, case management and discharge planning preferred.

Responsibilities

• Conduct timely admission and continued stay reviews with external payers.
• Verify active treatment by completing internal audit reviews within agreed time frames.
• Assist the treatment team during discharge planning and liaise with MD/Clinical Treatment Team.
• Report authorizations, denials, and documentation concerns; collaborate to minimize denials.

Skills

Clinical case management

Medical terminology

Interdisciplinary collaboration

Education

Bachelor's degree in social work/psychology/counseling/nursing

Master's degree preferred

Job description

Havenwyck Hospital in Auburn Hills, Michigan seeks an Utilization Management Case Manager to organize and conduct medical necessity reviews and discharge planning. Responsibilities include liaison with the Treatment Team and external payers to optimize resource use and ensure appropriate care levels.

The role requires a Bachelor’s degree in social work, psychology, counseling, or nursing, and relevant licensure. Two years of post-graduate psychiatric experience is preferred.