Hybrid Per Diem Utilization Management Case Manager

Universal Health Services; Dearborn (MI); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive compensation

Generous Paid Time Off

401(K) with company match

Career development opportunities

SoFi student loan refinancing program

Job summary

Metropolitan Health (a UHS Facility) in Dearborn, MI is seeking a Utilization Management Case Manager- Per Diem (Hybrid). The role oversees the managed care process, conducts timely admission and continued stay reviews with external payers, and applies approved criteria to determine medical necessity and level of care.

You will collaborate with the treatment team, assist discharge planning, and report authorizations/denials to minimize denials and optimize hospital resources.

Qualifications

• Bachelor's degree in social work or nursing or related health sciences field is highly desirable.
• Unrestricted licensed (LBSW, RN, LMSW, LPC, LMFT, etc.) is preferred.
• 2 years of related experience with psychiatric patient care knowledge is preferred.

Responsibilities

• Organize and conduct the managed care process for admissions and ongoing stays.
• Review utilization with external payers and determine medical necessity and level of care.
• Assist discharge planning and collaborate with the treatment team.
• Report authorizations/denials and minimize denials to optimize resources.

Skills

Communication skills

Team collaboration

Critical thinking

Education

Bachelor's degree in social work or nursing

Job description

Metropolitan Health (a UHS Facility) in Dearborn, MI is seeking a Utilization Management Case Manager- Per Diem (Hybrid). The role oversees the managed care process, conducts timely admission and continued stay reviews with external payers, and applies approved criteria to determine medical necessity and level of care.

You will collaborate with the treatment team, assist discharge planning, and report authorizations/denials to minimize denials and optimize hospital resources.