Healthcare Utilization Manager

5 days ago


Hamtramck, Michigan, United States Detroit Medical Center Full time

Estimated annual salary: $95,000 - $115,000

About the Role

We are seeking a skilled Healthcare Utilization Manager to join our team at the Detroit Medical Center. In this critical role, you will be responsible for ensuring that patients receive appropriate care while balancing clinical and financial requirements.

Job Summary
  • Facilitate effective resource coordination to optimize patient outcomes
  • Maintain accurate documentation of patient information and medical necessity screening
  • Collaborate with payors, physicians, and office staff to ensure seamless communication
Key Responsibilities
  • Balances clinical and financial requirements to advocate for patient needs
  • Promotes prudent utilization of resources by evaluating available resources and balancing cost and quality
  • Completes admission reviews for all payors and sends reviews for payors with an authorization process
Requirements and Qualifications
  • Registered Nurse (RN) license required
  • Experience in utilization management or case management preferred
  • Strong communication and organizational skills
About Us

The Detroit Medical Center is a leading academically-integrated hospital system in Metro Detroit, serving patients and families throughout Michigan and beyond. We offer a range of benefits and options to support our employees' health and well-being, including healthcare plans, dental and vision benefits, and an employee assistance program.

We value diversity and inclusion, and we are committed to maintaining an environment of equal opportunity and affirmative action. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran status, or disability.



  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    About the RoleWe 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 ResponsibilitiesBalances clinical and financial requirements...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    About the RoleIn this challenging and rewarding role, you will play a vital part in ensuring that patients receive the most appropriate care while maintaining efficient resource utilization.ResponsibilitiesYou will facilitate effective resource coordination to help patients achieve optimal health outcomes, access to care, and appropriate utilization of...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    About the JobAs a highly skilled Healthcare Management Professional, you will play a pivotal role in our Case Management team at the Detroit Medical Center. This is an exceptional opportunity to leverage your expertise and passion for delivering high-quality patient care while overseeing day-to-day operations of the department.In this dynamic position, you...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    About the JobAt Detroit Medical Center, we are seeking a highly skilled Medical Utilization Review Professional to join our team. This is a full-time days position.Job SummaryThe Medical Utilization Review Professional will be responsible for facilitating effective resource coordination to help patients achieve optimal health, access to care, and appropriate...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    About the RoleWe are seeking a highly skilled and experienced Case Manager to join our team at the Detroit Medical Center (DMC) in Michigan. This is a full-time position with a competitive salary of $80,000 per year.Job SummaryThe successful candidate will be responsible for managing and operating the Case Management and Social Work/Discharge Planning...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    About the Role:We are seeking an experienced Healthcare Operations Manager to join our team at the Detroit Medical Center. As a key member of our leadership team, you will be responsible for managing and coordinating the day-to-day operations of our healthcare services.Responsibilities:Manage and oversee the implementation of operational policies and...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    Job Summary">Detroit Medical Center seeks a highly skilled Nurse Manager to lead our Med Surg unit, ensuring exceptional patient care and operational efficiency. As a key member of our healthcare team, you will oversee daily activities, develop and implement policies, and collaborate with colleagues to achieve departmental goals.">About the Role">">Scope and...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    About the PositionAt Detroit Medical Center, we are seeking a highly skilled and experienced Healthcare Manager to lead our Telemetry Unit. This is an exciting opportunity to join our team and make a meaningful impact on patient care.Job DescriptionThe successful candidate will be responsible for managing and supervising a team of healthcare professionals,...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    At the Detroit Medical Center, we are seeking an experienced Nurse Director to lead our Telemetry department. This is a fantastic opportunity for a motivated and compassionate professional to join our team and make a meaningful impact on patient care.The successful candidate will be responsible for overseeing the day-to-day operations of the Telemetry unit,...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    At the Detroit Medical Center, we are committed to maintaining an environment of Equal Opportunity and Affirmative Action.We offer a range of benefits and options to help meet the needs of all eligible employees.The estimated salary for this role is around $85,000 - $110,000 per year, based on national averages for a Nurse Manager position in Detroit,...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    Job OverviewWe are seeking a Healthcare Operations Manager to join our team at the Detroit Medical Center. As a key member of our leadership team, you will be responsible for overseeing the operations of our Med Surg department, ensuring the highest level of patient care and satisfaction.About the RoleThe successful candidate will have a strong background in...


  • Hamtramck, Michigan, United States Executive Health Services, PLC Full time

    About Executive Health Services, PLCWe are a leading healthcare provider dedicated to delivering exceptional medical care to our patients. Our team of compassionate professionals is committed to providing personalized attention and cutting-edge treatment options.Job OpportunityWe are seeking an experienced Nurse Practitioner/Physician Assistant Bilingual...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    **Job Title:** Case Management Lead**About Us:The Detroit Medical Center (DMC) is a leading academically-integrated hospital system in Metro Detroit and one of the largest healthcare providers in Southeast Michigan.**Estimated Salary:** $105,000 - $120,000 per year**Job Description:We are seeking a highly skilled and experienced Case Management Lead to join...


  • Hamtramck, Michigan, United States Wayne Health Services Inc Full time

    **Company Overview:**Wayne Health Services Inc is a leading healthcare provider in the Detroit area, serving over one million patients and their families annually.We strive to advance medical knowledge, technologies and practices, and develop and educate the next generation of exceptional health care professionals.**Job Title:**Faculty Physician**Job...


  • Hamtramck, Michigan, United States Executive Health Services, PLC Full time

    Job DescriptionAs a Nurse Practitioner/Physician Assistant Bilingual Spanish/English at Executive Health Services, PLC, you will have the opportunity to work with a diverse patient population and develop your clinical skills in a dynamic and supportive environment.Key ResponsibilitiesProvide comprehensive medical care to patients in office, hospital, and...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    At the Detroit Medical Center, we are committed to providing exceptional patient care and improving health outcomes.About UsThe DMC is a leading academically-integrated hospital system in Metro Detroit, serving our community with compassion and expertise for over 150 years. We are proud of our rich history and legacy of caring for the people who call this...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    We are seeking a seasoned Nurse Case Manager to join our team at the Detroit Medical Center, where you will have the opportunity to make a meaningful impact on patient care and outcomes.About the RoleThis is a full-time position that requires strong clinical nursing skills, as well as exceptional communication and leadership abilities. As a Nurse Case...


  • Hamtramck, Michigan, United States Alkermes Full time

    About AlkermesAlkermes is a global biopharmaceutical company that applies its expertise in neuroscience to develop innovative medicines for complex and difficult-to-treat psychiatric and neurological disorders.We have a portfolio of proprietary commercial products for the treatment of alcohol dependence, opioid dependence, schizophrenia, and bipolar I...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    About the JobWe are seeking a dedicated and skilled Registered Nurse to join our team in Endoscopy at the Detroit Medical Center. This is an exciting opportunity to work in a dynamic and patient-centered environment where you can make a meaningful difference in the lives of our patients.Job ResponsibilitiesProvide high-quality patient care in a fast-paced...


  • Hamtramck, Michigan, United States Detroit Medical Center Full time

    About the PositionWe are seeking a skilled Registered Nurse to join our team in Detroit, Michigan.Job ResponsibilitiesProvide high-quality patient care and management as part of our interdisciplinary teamCollaborate with physicians and other healthcare professionals to develop and implement effective patient plansDelegate and supervise nursing activities to...