Healthcare Utilization Specialist

6 days ago


Hamtramck, Michigan, United States Detroit Medical Center Full time
About the Role

We are seeking a skilled Healthcare Utilization Specialist to join our team at the Detroit Medical Center. This role is responsible for facilitating effective resource coordination to help patients achieve optimal health, access to care, and appropriate utilization of resources.

Key Responsibilities
  • Balances clinical and financial requirements and resources in advocating for patient needs with judicious resource management
  • Promotes prudent utilization of all resources (fiscal, human, environmental, equipment, and services) by evaluating resources available to the patient and balancing cost and quality to assure optimal clinical and financial outcomes
Requirements
  • RN licensure in Michigan
  • 1+ years of experience in case management or utilization review
  • Strong understanding of medical necessity and denial prevention
Benefits

We offer a competitive salary range of $60,000 - $80,000 per year, based on experience, plus comprehensive benefits including health, dental, and vision insurance, 401(k) plan, and employee assistance program.



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