Top 51 Manager utilization management Jobs in Troy, Mi

Social Worker Care Manager- Contingent
McLaren Oakland —Pontiac, MI
- From $28.45 an hour
- Per diem
- BLS Certification
- Mid-level
- 3 years
- Health savings account
- Health insurance
Quick Apply
RN- Utilization Review/Case Manager
G-TECH Services, Inc. —Michigan
- $33 - $35 an hour
- Full-time
- Background check
- Nursing
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
2d
Registered Nurse- Integrated Care Manager PRN (Pontiac)
McLaren Oakland —Pontiac, MI
- From $35.84 an hour
- Weekends as needed
- Nursing
- RN License
- Hospital
- Free parking
- Health savings account
Quick Apply
Manager, Regional Clinical Nutrition and Wellness - West Region -- Remote
Trinity Health —Livonia, MI
- $98,240 - $147,360 a year
- Full-time
- Remote
- 7 years
- Microsoft Outlook
- Master's degree
- Wellness program
- Opportunities for advancement
Manager of Operations (Detroit, MI / Hybrid)
FreedomCare —Detroit, MI
- $100,000 - $120,000 a year
- Full-time
- Hybrid work
- 5 years
- Mid-level
- Office
- Health insurance
- Retirement plan
Quick Apply
Care Manager I
Trinity Health —Pontiac, MI
- Full-time
- CPR Certification
- Nursing
- Microsoft Excel
2d
Virtual Reimbursement Manager
Syneos Health Commercial Solutions —Detroit, MI
- Mid-level
- Bachelor's degree
- In-person
- Health insurance
- Dental insurance
Medical Equipment Operations Area Manager HYBRID
Rotech Healthcare Inc. —Livonia, MI
- Full-time
- Microsoft Word
- Background check
- Clean driving record
- Opportunities for advancement
Quick Apply
10d
Utilization Review Manager
Harbor Oaks Hospital —New Baltimore, MI
- $25 - $35 an hour
- Full-time
- CPR Certification
- RN License
- BLS Certification
20h
Virtual Reimbursement Manager
サイネオス・ヘルス —Detroit, MI
- Mid-level
- Bachelor's degree
- In-person
- Health insurance
- Dental insurance
Care Manager I - Hybrid
Trinity Health - IHA —Pontiac, MI
- Full-time
- CPR Certification
- Nursing
- Microsoft Excel
Social Work Care Manager
McLaren Oakland —Pontiac, MI
- Per diem
- Surgery
- Hospital
- BLS Certification
Radiology Manager - Medical Imaging - 40 Hours Weekly - Day Shift
Henry Ford Health —Detroit, MI
- Full-time
- Hospital
- Mid-level
- Windows
- Health insurance
- Dental insurance
Healthcare Operations Manager
HR Alliance —Dearborn, MI
- $70,000 - $80,000 a year
- Full-time
- Applied behavior analysis
- HIPAA
- Mid-level
Quick Apply
10d
Care Manager II
Amerihealth Caritas —Southfield, MI
- Full-time
- Nursing
- Microsoft Outlook
- RN License
9d
Case Manager
Trinity Health Michigan —Livonia, MI
- Part-time
- Acute care
- Nursing
- RN License
- Free parking
- Disability insurance
6d
Case Manager - PSH
Pioneer Health Care Management Inc —Pontiac, MI
- $80,000 a year
- RN License
- Inpatient
- Mid-level
Quick Apply
13d
Social Work Care Manager
Barbara Ann Karmanos Cancer Cn —Detroit, MI
- Weekends as needed
- Surgery
- Hospital
- BLS Certification
Case Manager
Matrix Human Services —Ferndale, MI
- $55,000 a year
- Weekends as needed
- Microsoft Outlook
- Computer literacy
- Writing skills
- AD&D insurance
- Paid holidays
Quick Apply
Senior Community Care Manager
Amerihealth Caritas —Southfield, MI
- Full-time
- Nursing
- RN License
- Mid-level

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manager utilization management jobs near troy, mi

Social Worker Care Manager- Contingent

McLaren Oakland -
Pontiac, MI

Quick Apply

Job Details

Per diem
From $28.45 an hour

Benefits

Health savings account
Health insurance
Dental insurance
Paid time off
Vision insurance
403(b)
Life insurance
Retirement plan

Qualifications

LMSW
Triage
BLS Certification
Master's degree
Certified Social Worker
Acute care experience
Social Work
Certified Case Manager

Full Job Description

Department: Case Management

Shift: Days

Schedule: Contingent PRN

Daily Work Times: 8:00am-4:30pm

Position Summary: Provides assessment and intervention to assist clients/families to improve social and economic difficulties interfering with health and wellness through use of casework process and principles, strategies, and community resources. Provides professional discharge planning services through assessments, and coordination of post hospital care needs to patients and their families, providing them with resources and choices to effectively link them to the needed level of emotional, medical and spiritual care. Receives referrals for individuals from at-risk populations from interdisciplinary team members.

Essential Functions and Responsibilities as Assigned:

1. Performs high level triage of all patients, with focus on identifying those with complex psych-social or financial issues, placement needs and community service needs within 24 hours of admission.

2. Receives RN Care Manager referrals to social work based on identified Social Work Triggers (see SW Referral Standard Operating Procedure - SOP).

3. Identifies and assesses barriers early in the patient’s stay, formulating a plan with the patient, family, internal and external members of the healthcare team, payers, and community resources. (e.g., LOS barriers to D/C)

4. Assesses patient and family needs for support and community service needs (Meals on Wheels, Sitters, etc.); educates and refers them to community resources, access to services, arrange for appointments and establishes rapport with other agencies.

5. Assesses risk of readmission for specified patient populations and initiates assigned interventions that will enhance the patient’s ability to successfully transition along the care continuum.

6. Identifies the need for, arranges, and participates in family care conferences; participates in interdisciplinary conferences and provides consultation for patient, families, and clinical staff (e.g., attends care conferences/unit rounds/huddles).

7. Identifies and reports avoidable day/variances and/or service delays from established plan of care to leadership.

8. Identifies patient and family preferences, needs and strengths, to foster for the interdisciplinary team in compliance with standards of care.

9. Interviews patient and significant others to assess patient’s psychosocial situation and identifies which family member is the point of contact.

10. Develops discharge plan in direct consultation with patient, family, physician, and health care team.

11. Manages complex cases/situations and intervenes with and advocates for patients and families as plan of care and discharge plan are developed. Complex discharge planning identified from SW triggers (see SW Referral Standard Operating Procedure - SOP)

12. Uses knowledge of insurance benefits and coverage guidelines to maximize appropriate utilization of resources.

13. Documents in the EMR: assessment, plans, interventions, barriers, and reassessments as necessary to facilitate discharge and/or transitions; ensures all pertinent information is transferred to post-acute agency.

14. Works collaboratively with the RN Care Manager, other disciplines, and internal and external members of the healthcare team to ensure a safe, appropriate, and timely transition to the next level of care, taking into consideration the patient’s available resources.

15. Partners with external agencies and facilities to provide continuity of care for patient and family empowerment and independence to make autonomous health decisions.

16. Represents the integrated care management department on various teams and performance outcomes committees and projects.

17. Performs other related duties as required and directed.

Qualifications:

Required:

Fully licensed Master’s Social Worker (LMSW); LMSW certification within one year of eligibility and maintenance of continuing education requirements

Preferred:

Certification in Case Management Certification (ACM or CCM)
Three years acute hospital care or social work experience
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)

Pay: From $28.45 per hour

Benefits:

403(b)
Dental insurance
Health insurance
Health savings account
Life insurance
Paid time off
Retirement plan
Vision insurance

Education:

Master's (Required)

License/Certification:

Certified Social Worker (Required)

Work Location: In person

Quick Apply

Refine Your Search

manager utilization management jobs in troy, mi

Social Worker Care Manager- Contingent

RN- Utilization Review/Case Manager

Registered Nurse- Integrated Care Manager PRN (Pontiac)

Manager, Regional Clinical Nutrition and Wellness - West Region -- Remote

Manager of Operations (Detroit, MI / Hybrid)

Care Manager I

Virtual Reimbursement Manager

Medical Equipment Operations Area Manager HYBRID

Utilization Review Manager

Virtual Reimbursement Manager

Care Manager I - Hybrid

Social Work Care Manager

Radiology Manager - Medical Imaging - 40 Hours Weekly - Day Shift

Healthcare Operations Manager

Care Manager II

Case Manager

Case Manager - PSH

Social Work Care Manager

Case Manager

Senior Community Care Manager

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