Integrated Care Management Assistant Utilization Management

2 months ago

Detroit, United States McLaren Health Care Full time

Position Summary: Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay reviews, as well as, performing clerical functions to ensure the efficient operation of the ICM department. Essential Functions and Responsibilities as Assigned: Collaborates with the UM RN to determine the appropriate hospital setting (inpatient vs. observation) based on medical necessity. Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data are tracked, evaluated, and reported including Important Message from Medicare (IMM) and Medicare Outpatient Observation Notice (MOON) completion. Communicates clinical information with payors via phone, fax, and computer system per payer contract to obtain authorization for appropriate level of care and length of stay as needed. Obtains authorization for admission / concurrent stay for designated units. Provides prompt feedback regarding payor determinations to UM RN. Attends meetings and prepares agendas and minutes. Handles incoming and outgoing office correspondence; answers and directs department phone calls as needed. Performs general office duties including faxing, copying, scanning and filing. Orders department supplies. Communicates with internal and external customers to answer questions. Troubleshoots problems that arise with office equipment. Notifies leadership of unresolved issues. Performs other related duties as required and directed. Qualifications: Required Associate degree in healthcare-related field Two years of clerical experience One-year experience in a heath care environment utilizing medical terminology or have completed a college level course in medical terminology Preferred: Bachelor’s degree in coding/medical records/billing or healthcare related field Two years of case management or utilization review, billing, or coding experience Three years of recent experience doing third party payer certification Basic Life Support (BLS) certification as a Healthcare Provider by the American Heart Association, American Red Cross or equivalent through the Military Training network (MTN) Knowledge, Skills, and Abilities: Ability to handle multiple tasks and complete work within short timeframes. Ability to understand, interpret, explain, and use data for case management activities. Ability to work with diverse teams and individuals, team player. Able to spend majority of time utilizing a computer, monitor, keyboard and mouse; ability to type. Competency in applying the principles, methods, materials, and equipment necessary inproviding utilization management services. Demonstrated expertise in utilization management principles, methods, and tools and incorporating them into the daily operations of the organization. Excellent time management and organization skills. Knowledge of care delivery systems across the continuum of care including, but not limited to, trends and issues in care reimbursement, medical necessity and assigning level of care assignment (inpt vs obs). Must be able to act calmly and effectively in busy/stressful environment. Must be able to work independently, and utilize problem solving techniques and critical thinking skills. Proficient with Microsoft Office (i.e., Word, Excel, Outlook, and Power Point). Strong verbal and written communication skills: ability to interact productively with leaders, peers, and customers. Must be able to travel to subsidiaries or corporate meetings as needed. Weekend, holiday, and evening coverage as per site requirements.

  • Integrated Care Management Assistant Utilization Management

    2 months ago

    Detroit, United States McLaren USA Full time

    Position Summary: Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay reviews, as well as, performing clerical functions to ensure the efficient operation of the ICM department. Essential Functions and Responsibilities as Assigned: Collaborates with the UM RN to determine the...

  • Clinical Utilization Manager

    3 weeks ago

    Detroit, Michigan, United States Detroit Medical Center Full time

    About the RoleWe are seeking an experienced Clinical Utilization Manager to join our team at the Detroit Medical Center. This is a full-time, day shift position that requires 36 hours of work per week.ResponsibilitiesBalancing clinical and financial requirements and resources in advocating for patient needs with judicious resource managementPromotes prudent...

  • Assistant Property Manager

    18 hours ago

    Detroit, Michigan, United States SUNBEAM PROPERTY & CONSTRUCTION MANAGEMENT Full time

    Company OverviewSunbeam Property & Construction Management is a thriving property management company that manages over 300 multi and single-family homes throughout the Metro Detroit Area.Salary$17/hour, with opportunities for commission and bonuses.Job DescriptionWe are seeking an experienced Assistant Property Manager to join our team. The ideal candidate...

  • Corporate Travel Management Expert

    5 days ago

    Detroit, Michigan, United States ADTRAV Travel Management Full time

    Key ResponsibilitiesThe key responsibilities of this role include answering client calls and emails promptly, utilizing Sabre to book and issue travel arrangements accurately and efficiently, maintaining account knowledge to assist clients without delay, and checking queues daily to ensure accuracy and completeness of issued tickets. Additionally, you will...

  • Assistant Property Manager

    4 days ago

    Detroit, Michigan, United States SUNBEAM PROPERTY & CONSTRUCTION MANAGEMENT Full time

    Job DescriptionWe are seeking an experienced Assistant Property Manager to join our team at SUNBEAM PROPERTY & CONSTRUCTION MANAGEMENT. As a key member of our property management team, you will be responsible for all aspects of marketing, leasing, and day-to-day administrative duties. This role requires strong organizational skills, attention to detail, and...

  • Travel Management Professional

    5 days ago

    Detroit, Michigan, United States ADTRAV Travel Management Full time

    ADTRAV Travel Management is seeking a Government Travel Consultant to be responsible for all aspects of travel management for our government clients. The estimated salary for this position is around $55,000-$65,000 per year, based on the location and industry standards.Job DescriptionThe Government Travel Consultant will be responsible for conversing with...

  • Assistant Property Operations Manager

    2 days ago

    Detroit, Michigan, United States SUNBEAM PROPERTY & CONSTRUCTION MANAGEMENT Full time

    Job DescriptionSunbeam Property & Construction Management is seeking a highly skilled Assistant Property Manager to join our team in the Metro Detroit Area. The successful candidate will be responsible for all aspects of property operations, including marketing, leasing, and administrative duties.Responsibilities:Marketing and Leasing:Show properties to...

  • Utilization Management Professional

    5 days ago

    Detroit, Michigan, United States LanceSoft Full time

    About the RoleWe are looking for a skilled Utilization Management Professional who can analyze healthcare data to identify areas for improvement. As a key member of our team, you will work closely with healthcare providers and administrators to develop effective care plans and coordinate patient care across the continuum.

  • Portfolio Manager with Rural Development Expertise

    16 hours ago

    Detroit, Michigan, United States Madison Management Full time

    Job Title: Relocate - Affordable Portfolio Property ManagerWe are seeking a seasoned Compliance/Portfolio Property Manager to join our team at Madison Management in Alpena, MI. As a key member of our organization, you will be responsible for overseeing the management of five rental agents for rural development, Section 42 and HUD properties.This role offers...

  • Grounds Management Team Members

    2 days ago

    Detroit, Michigan, United States Trosini Landscape Management Full time

    Job DescriptionAs a member of our landscape management team, you will play a vital role in maintaining the beauty and integrity of our clients' properties. Your responsibilities will include:Lawn maintenance, pruning, and plantingEquipment operation and maintenanceCustomer service and communicationWe offer a generous salary of $60,000 - $80,000 per year,...

  • Medical Director for Utilization Management

    3 weeks ago

    Detroit, Michigan, United States Henry Ford Hospital Full time

    At Henry Ford Hospital, excellence in patient care is a top priority. Our team of healthcare professionals strives to deliver high-quality care every day. We encourage collaboration and participation in quality assurance activities, research, and shared governance to make a positive impact on patient outcomes.We utilize evidence-based practice, professional...

  • Post-Acute Care Utilization Manager

    5 days ago

    Detroit, Michigan, United States LanceSoft Full time

    About LanceSoftLanceSoft is committed to creating a fair and inclusive work environment that respects all individuals. We base our hiring decisions solely on qualifications, merit, and business needs.Job DescriptionThis role involves utilizing established medical policies and guidelines to conduct reviews of post-acute care services. The successful candidate...

  • Property Management Associate

    18 hours ago

    Detroit, Michigan, United States SUNBEAM PROPERTY & CONSTRUCTION MANAGEMENT Full time

    About SUNBEAM PROPERTY & CONSTRUCTION MANAGEMENTSUNBEAM PROPERTY & CONSTRUCTION MANAGEMENT is a leading property management company that specializes in managing multi-family homes throughout the Metro Detroit Area. We offer a dynamic work environment and opportunities for professional growth and development.Job Description:This Assistant Property Manager...

  • Utilization Management Coordinator

    4 weeks ago

    Detroit, Michigan, United States McLaren USA Full time

    Job OverviewWe are seeking a skilled Utilization Management Coordinator to join our team at McLaren USA. This role will play a crucial part in determining hospital settings based on medical necessity, performing concurrent and retrospective utilization management activities, communicating with payors, and obtaining authorization for care.Key...

  • Property Management Professional

    4 weeks ago

    Detroit, Michigan, United States SUNBEAM PROPERTY & CONSTRUCTION MANAGEMENT Full time

    Assistant Property ManagerWe are seeking an experienced Assistant Property Manager to join our thriving property management company, Sunbeam Property & Construction Management.Job OverviewSunbeam Property & Construction Management manages over 300 multi and single-family homes throughout the Metro Detroit Area. The successful candidate will be responsible...

  • Property Management Professional

    16 hours ago

    Detroit, Michigan, United States SUNBEAM PROPERTY & CONSTRUCTION MANAGEMENT Full time

    About UsSunbeam Property & Construction Management is a leading property management company in the Metro Detroit Area, managing over 300 properties.Job SummaryWe are seeking an experienced Assistant Property Manager to join our team. As a successful Assistant Property Manager, your goal will be to achieve and maintain high occupancy rates while maximizing...

  • Corporate Travel Management Professional

    19 hours ago

    Detroit, Michigan, United States ADTRAV Travel Management Full time

    Job DescriptionADTRAV Travel Management is seeking an experienced Travel Consultant to manage all aspects of travel management for our government clients. This includes conversing with customers through multiple communication channels to determine destination, mode of transportation, travel dates, financial considerations, and accommodations...

  • Utility Construction Assistant

    2 weeks ago

    Detroit, Michigan, United States Corby Energy Services, Inc. Full time

    Job Title: Utility Construction AssistantLocation: Detroit, MIWe are seeking a skilled and detail-oriented individual to assist our utility construction team in Detroit, MI. As a Utility Construction Assistant, you will play a critical role in maintaining shop operations, ensuring an efficient and organized workspace, and supporting overall shop...

  • Travel Management Specialist

    4 days ago

    Detroit, Michigan, United States ADTRAV Travel Management Full time

    Job OverviewADTRAV Travel Management is a leading provider of corporate travel management solutions, seeking a highly skilled Government Travel Consultant to join our team. In this role, you will be responsible for managing all aspects of government client travel programs, ensuring seamless and efficient travel experiences.

  • Nurse Manager Behavioral Health

    4 weeks ago

    Detroit, United States Clinical Management Consultants Full time

    Join a dynamic healthcare team where excellence in patient care is the top priority. We are seeking a passionate and experienced leader to take on a critical role in a major healthcare institution known for its commitment to community health and cutting-edge medical services. This top-tier healthcare facility is part of a nationally recognized network,...