Hybrid Utilization Case Manager

UHS of Delaware, Inc.; Dearborn, Northern (MI, KY); Hybrid; USD 60,000 - 85,000; Part time

Benefits offered by this job

Competitive compensation

Excellent health plans (medical,Dental

Vision and Prescription Drug Plans

401(k) with company match

SoFi student loan refinancing

Career development opportunities

Job summary

Metropolitan Behavioral Hospital, part of Universal Health Services (UHS), seeks a Utilization Management Case Manager- Per Diem to organize and conduct the managed care process. This hybrid role involves admissions reviews, determining medical necessity, discharge planning support, and cross-department collaboration to optimize hospital resources.

The ideal candidate holds a related degree (BS or MS in social work, counseling, or nursing) and an unrestricted license, with approximately two

Qualifications

• Bachelor's degree in social work, counseling or nursing or a master's in social work or related health sciences.
• Unrestricted license (LBSW, RN, LMSW, LLP, LPC, LMFT, etc.)
• Two years of related psychiatric patient care experience; understanding of mental illness.

Responsibilities

• Organize and conduct the managed care process to support the hospital's mission.
• Perform timely admission and continued stay record reviews with external payers.
• Use approved criteria to determine medical necessity and level of care planning.
• Assist discharge planning and liaise with treatment team and external agencies.
• Report authorizations, denials, and documentation concerns; collaborate across departments to minimize denials.

Skills

Two years experience

Education

Bachelor's degree in social work, counseling or nursing

Master's degree in social work or counseling

Job description

Metropolitan Behavioral Hospital, part of Universal Health Services (UHS), seeks a Utilization Management Case Manager- Per Diem to organize and conduct the managed care process. This hybrid role involves admissions reviews, determining medical necessity, discharge planning support, and cross-department collaboration to optimize hospital resources.

The ideal candidate holds a related degree (BS or MS in social work, counseling, or nursing) and an unrestricted license, with approximately two