Hybrid Utilization Management Case Manager | Per Diem

UHS of Delaware, Inc.; Dearborn (MI); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Challenging and rewarding environment

Competitive compensation & generous PT

Excellent health plans

401(k) with company match

Student loan refinancing

Career development opportunities

Job summary

Metropolitan Behavioral Hospital in Dearborn, MI, part of Universal Health Services, is seeking a Utilization Management Case Manager- Per Diem (Hybrid). You will organize and conduct the managed care process, perform admission and continued stay reviews with external payers, and apply approved criteria to determine medical necessity and level of care.

You will collaborate with the treatment team and external agencies, support discharge planning, and document authorizations and denials.

Qualifications

• Bachelor's degree from an accredited college or university in social work, counseling or nursing; or a master's degree from an accredited college or university in social work or counseling or similar health sciences field is highly desirable.
• Unrestricted license (LBSW, RN, LLMSW, LMSW, LLP, LP, LPC, LMFT, etc.)
• Two years of related experience, with knowledge of psychiatric patient care techniques and understanding of mental illness.

Responsibilities

• Organize and conduct the managed care process.
• Conduct admission and continued stay record reviews with external payers.
• Utilize approved criteria to determine medical necessity and level of care planning.
• Verify active treatment by completing internal audit reviews within approved time frames.
• Assist the treatment team in discharge planning when indicated.
• Act as liaison with MD/Clinical Treatment Team and external agencies.
• Report authorizations, denials, and documentation concerns; collaborate across departments to minimize denials and optimize hospital resources.

Education

Bachelor's degree in social work, counseling or nursing

Master's degree in social work or counseling or similar health sciences

Job description

Metropolitan Behavioral Hospital in Dearborn, MI, part of Universal Health Services, is seeking a Utilization Management Case Manager- Per Diem (Hybrid). You will organize and conduct the managed care process, perform admission and continued stay reviews with external payers, and apply approved criteria to determine medical necessity and level of care.

You will collaborate with the treatment team and external agencies, support discharge planning, and document authorizations and denials.