Utilization Management Case Manager

Havenwyck Hospital Inc.; Auburn Hills (MI); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive compensation

Generous paid time off

Medical, dental, vision and Rx plan

401(k) with company match

Career development opportunities

SoFi student loan refinancing program

Student loan repayment program

Job summary

Havenwyck Hospital in Auburn Hills, MI seeks a Utilization Management Case Manager to organize and conduct the managed care process, supporting the hospital's mission of excellence in care and service.

You will review admissions and stays with external payers, apply criteria to determine medical necessity and level of care, assist discharge planning, and coordinate with the treatment team and external agencies.

Qualifications

• Bachelor degree in social work, psychology, counseling or nursing required.
• Master's degree in social work, psychology, or counseling preferred.
• Limited or fully licensed (LBSW, RN, LLMSW, LLP, TLLP, LPC, LMFT, etc.).
• A minimum of 2 years of post-graduate related experience in psychiatric or substance abuse treatment required.
• Familiarity with manager health care process, medical terminology, experience in case management, discharge planning, and/or utilization review preferred.

Responsibilities

• Through clinical skills (experience and knowledge), reports to external insurance and review entities an accurate presentation of the medical management of a patient's illness, length of stay and care alternatives available within the confines on the client's benefits and financial resources.
• Communicates with the Treatment Team (physicians, nursing staff, social workers, etc.) as necessary to advocate for the patient's clinical treatment within the confines on the client's benefits and financial resources.
• Using clinical skills (experience and knowledge) assists the team in ensuring the completeness and accuracy of the medical records.
• Performs other related duties as assigned.

Education

Bachelor Degree in social work, psychology, counseling or nursing

Master's degree in social work, psychology, or counseling

Job description

Responsibilities

HAVENWYCK HOSPITAL (a UHS facility)

Havenwyck Hospital is a Joint Commission-accredited and licensed psychiatric hospital, overlooking Lake Galloway in Auburn Hills, Michigan. We specialize in providing comprehensive, compassionate behavioral health services to children, adolescents and adults. It is the ultimate goal of our dedicated staff to build strength, confidence and knowledge within each patient, in hopes that they may continue learning and understanding their needs and practicing self-care for the rest of their lives.

If you would like to learn more about this position before applying, please contact Havenwyck Hospital at 248-373-9200.

POSITION SUMMARY:

The Utilization Management Case Manager has a responsibility for organizing and conducting the manager care process. These duties shall be directed toward supporting the hospital's mission in the pursuit of excellence in care/service and will include (but not limited to ): conducting timely admission and continues stay record reviews with external payers, utilizing approved criteria to make determinations of medical necessity and level of care planning, verifying active treatment by completing internal audit reviews within approved time frames, assisting the treatment team when indicated in the discharge planning process, and acting as liaison with MD/Clinical Treatment Team and external agencies. Report authorizations, denials, and documentation concerns, as well as collaborate effectively across departments to minimize denials/facilitate optimal use of hospital resources.

DUTIES AND RESPONSIBILITIES:

• Through clinical skills (experience and knowledge), reports to external insurance and review entities an accurate presentation of the medical management of a patient's illness, length of stay and care alternatives available within the confines on the client's benefits and financial resources.
• Communicates with the Treatment Team (physicians, nursing staff, social workers, etc.) as necessary to advocate for the patient's clinical treatment within the confines on the client's benefits and financial resources.
• Using clinical skills (experience and knowledge) assists the team in ensuring the completeness and accuracy of the medical records.
• Performs other related duties as assigned.

BENEFIT HIGHLIGHTS:

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plan
• 401(K) with company match and discounted stock plan
• Career development opportunities within UHS and its 300+ Subsidiaries
• Free Basic Life Insurance
• Tuition Reimbursement
• SoFi Student Loan Refinancing Program
• Student Loan Repayment Program - for some degrees and criteria

What do our current employees value at Havenwyck Hospital and UHS?

An environment that puts patient care first. One of the most rewarding aspects of this job is providing excellent care, comfort, and security to the patients and families you treat, at their most vulnerable times. Supportive and responsive leadership. You are never alone, as you are part of a large network of peer co-workers that routinely exchange ideas and review current topics within the industry. Having the opportunity to grow, learn, and advance in your career. There are very robust continuing education options and opportunities for skills diversification and career advancement with UHS.

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World's Most Admired Companies™ and in 2025, was listed in Forbes ranking of America's Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

Qualifications

QUALITICATIONS:

• Bachelor Degree in social work, psychology, counseling or nursing required. Master's degree in social work, psychology, or counseling preferred.
• Limited or fully licensed (LBSW, RN, LLMSW, LLP, TLLP, LPC, LMFT, etc.).
• A minimum of 2 years of post-graduate related experience in psychiatric or substance abuse treatment required. Hospital utilization review/utilization management experience preferred.
• Familiarity with manager health care process, medical terminology, experience in case management, discharge planning, and/or utilization review preferred.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.