Medical Case Manager

7 days ago


Detroit, Michigan, United States Detroit Medical Center Full time
Job Overview

The Detroit Medical Center is seeking a highly skilled Medical Case Manager to join our team in Detroit, Michigan. As a key member of our Utilization Review department, you will play a critical role in ensuring that patients receive the most appropriate level of care while maintaining fiscal responsibility.

About Us

The Detroit Medical Center is a nationally recognized health care system that serves patients and families throughout Michigan and beyond. Our mission is to help people live happier, healthier lives through evidence-based practices and compassionate care. We are committed to maintaining an environment of Equal Opportunity and Affirmative Action, and we welcome qualified applicants from diverse backgrounds.

Job Responsibilities

As a Medical Case Manager - Utilization Review RN, your primary responsibilities will include:

• Facilitating effective resource coordination to ensure patients achieve optimal health outcomes
• Collaborating with payors, physicians, office staff, and ancillary departments to negotiate authorization for services and optimize patient care
• Managing concurrent disputes and identifying opportunities for cost savings without compromising patient care
• Maintaining accurate and timely documentation in Tenet's Case Management system
• Identifying and reporting variances in medical necessity and resource utilization compared to evidence-based practices

Requirements

To be successful in this role, you will need to possess excellent communication and collaboration skills, as well as strong analytical and problem-solving abilities. You should have experience working in case management or a related field, and be proficient in Microsoft Office and other software applications. A strong understanding of healthcare regulations and accreditation standards is also essential.

Benefits

The Detroit Medical Center offers a comprehensive benefits package, including medical, dental, and vision coverage, as well as life insurance, disability insurance, and 401(k) retirement plan options. We also offer flexible scheduling and paid time off to support work-life balance. In addition, you will have access to professional development opportunities and continuing education resources to enhance your skills and career growth.

Estimated Salary Range: $85,000 - $105,000 per year

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