Senior Utilization Manager, Case Management

DMC Group; Detroit (MI); On-site; USD 120,000 - 160,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) with employer match

Generous PTO

Career development opportunities

Health savings accounts

Job summary

Detroit Medical Center seeks a results-driven healthcare leader to drive utilization review and case management excellence. You will oversee staff, ensure medical necessity, and coordinate payer negotiations for timely patient throughput and safe discharge.

The role requires an active RN license with hospital case management or leadership experience; a BSN is preferred. You will collaborate with physicians and hospital leaders to improve outcomes and financial performance.

Qualifications

• Active Registered Nurse license required.
• At least two years in hospital case management, utilization review, healthcare leadership, or related leadership roles.
• Strong organizational, communication, and problem-solving skills.

Responsibilities

• Facilitate and support an effective Utilization Review program within Case Management.
• Ensure care at appropriate level based on medical necessity and promote timely discharge.
• Coordinate education for physicians, staff and leaders; monitor and report UR/CC metrics.

Skills

RN license

Healthcare leadership

Acute hospital experience

Education

BSN preferred

Job description

Detroit Medical Center seeks a results-driven healthcare leader to drive utilization review and case management excellence. You will oversee staff, ensure medical necessity, and coordinate payer negotiations for timely patient throughput and safe discharge.

The role requires an active RN license with hospital case management or leadership experience; a BSN is preferred. You will collaborate with physicians and hospital leaders to improve outcomes and financial performance.