Utilization Management Case Manager- Per Diem (Hybrid)

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

Responsibilities

Utilization Management Case Manager- Per Diem (Hybrid)

Metropolitan Health (a UHS Facility)

A growing, 144-bed behavioral health facility – Metropolitan Behavioral Hospital provides a full continuum of inpatient services across the entire patient population, including specialty programs to serve adolescents, adults and older adults, and perform behavioral health assessments 24 hours a day. Additionally, programs for co-occurring behavioral health and substance use issues are offered to meet the unique needs of this patient population. The facility will provide a robust outpatient program utilizing a combination of group, family and individual therapy.

https://metropolitanbh.com

Position Summary:

The Utilization Management Case Manager- Per Diem (Hybrid) has responsibility for organizing and conducting the managed 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 continued 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.

Benefit Highlights

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

Qualifications

Qualifications

Education: 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.

License: Unrestricted limited or full licensed (LBSW, RN, LLMSW, LMSW, LLP, LP, LPC, LMFT, etc.)

Experience: Two (2) years of related experience, with knowledge of psychiatric patient care techniques with understanding of mental illness, 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.