Case Manager
Detroit, MI · On-site
$58 - $60/hr
MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.
Quick apply
Case Manager
Detroit, MI · On-site
$58 - $60/hr
MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.
Case Manager
Detroit, MI · On-site
$55 - $60/hr
MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.
Quick apply
Case Manager
Detroit, MI · On-site
$55 - $60/hr
MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.
Case Manager
Livonia, MI · On-site
$18.75 - $24/hr
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. Current knowledge of third party payor ...
Case Manager
Livonia, MI · On-site
$18.75 - $24/hr
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. Current knowledge of third party payor ...
Case Manager
Livonia, MI · On-site
$18.75 - $24/hr
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. • Current knowledge of third party payor ...
Case Manager
Livonia, MI · On-site
$18.75 - $24/hr
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. • Current knowledge of third party payor ...
Case Manager
$18.75 - $24/hr
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. Current knowledge of third party payor ...
Case Manager
$18.75 - $24/hr
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. Current knowledge of third party payor ...
Case Manager
Brighton, MI · On-site
$19.25 - $24.75/hr
Case Manager - Brighton Center For Recovery Be a vital advocate at the center of patient care. In ... Serve as a clinical documentation and utilization resource , supporting accurate medical records ...
Case Manager
Brighton, MI · On-site
$19.25 - $24.75/hr
Case Manager - Brighton Center For Recovery Be a vital advocate at the center of patient care. In ... Serve as a clinical documentation and utilization resource , supporting accurate medical records ...
Case Manager
Ferndale, MI · On-site
$55K/yr
... service utilization eliminating any gaps in care. The Case Manager works closely with the patient's medical provider to understand what the patient's medical needs are in addition to their ...
Case Manager
Ferndale, MI · On-site
$55K/yr
... service utilization eliminating any gaps in care. The Case Manager works closely with the patient's medical provider to understand what the patient's medical needs are in addition to their ...
Case Manager
Ferndale, MI · On-site
$55K/yr
... service utilization eliminating any gaps in care. The Case Manager works closely with the patient's medical provider to understand what the patient's medical needs are in addition to their ...
Case Manager
Ferndale, MI · On-site
$55K/yr
... service utilization eliminating any gaps in care. The Case Manager works closely with the patient's medical provider to understand what the patient's medical needs are in addition to their ...
Case Manager - PSH
Garden City, MI · On-site
$80K/yr
Review pre-admission screening for utilization review, funding and discharge planning issues ... Case Management Experience required
Quick apply
Case Manager - PSH
Garden City, MI · On-site
$80K/yr
Review pre-admission screening for utilization review, funding and discharge planning issues ... Case Management Experience required
Case Manager - PSH
Pontiac, MI · On-site
$80K/yr
Review pre-admission screening for utilization review, funding and discharge planning issues ... Case Management Experience required
Quick apply
Case Manager - PSH
Pontiac, MI · On-site
$80K/yr
Review pre-admission screening for utilization review, funding and discharge planning issues ... Case Management Experience required
Case Manager
Brighton, MI · On-site
$19.25 - $24.75/hr
Case Manager - Brighton Center For Recovery Be a vital advocate at the center of patient care. In ... Serve as a clinical documentation and utilization resource , supporting accurate medical records ...
Case Manager
Brighton, MI · On-site
$19.25 - $24.75/hr
Case Manager - Brighton Center For Recovery Be a vital advocate at the center of patient care. In ... Serve as a clinical documentation and utilization resource , supporting accurate medical records ...
Assists with utilization management reporting, data collection, and performance improvement initiatives as requested. 12. Demonstrates service excellence by providing complete clinical information to ...
New
Assists with utilization management reporting, data collection, and performance improvement initiatives as requested. 12. Demonstrates service excellence by providing complete clinical information to ...
New
Case Manager-SW Afternoons
$19.75 - $25.50/hr
Knowledge of computers, Electronic Health Records, data base systems and utilization review/case management documentation systems. Desire to work collaboratively and proactively with healthcare teams ...
Case Manager-SW Afternoons
$19.75 - $25.50/hr
Knowledge of computers, Electronic Health Records, data base systems and utilization review/case management documentation systems. Desire to work collaboratively and proactively with healthcare teams ...
RN Case Manager
Pontiac, MI · On-site
$2.1K - $2.2K/wk
Requirement Description: 2+ Years Case Management - Required 3 years acute hospital care experience ... starting Utilization Review - Preferred Insurance Authorization experience - Preferred CCM ...
Quick apply
RN Case Manager
Pontiac, MI · On-site
$2.1K - $2.2K/wk
Requirement Description: 2+ Years Case Management - Required 3 years acute hospital care experience ... starting Utilization Review - Preferred Insurance Authorization experience - Preferred CCM ...
RN- Case Manager
Pontiac, MI · On-site
$2.1K - $2.2K/wk
Description: 2+ Years Case Management - Required 3 years acute hospital care experience - Required ... starting Utilization Review - Preferred Insurance Authorization experience - Preferred CCM ...
Quick apply
RN- Case Manager
Pontiac, MI · On-site
$2.1K - $2.2K/wk
Description: 2+ Years Case Management - Required 3 years acute hospital care experience - Required ... starting Utilization Review - Preferred Insurance Authorization experience - Preferred CCM ...
Assists with utilization management reporting, data collection, and performance improvement initiatives as requested. 12. Demonstrates service excellence by providing complete clinical information to ...
New
Assists with utilization management reporting, data collection, and performance improvement initiatives as requested. 12. Demonstrates service excellence by providing complete clinical information to ...
New
Case Management
Livonia, MI · On-site
An Opportunity to Join our Remarkable Care as a Case Manager awaits YOU!!!! Trinity Health Livonia ... Five years of clinical experience in nursing and recent (within 2 year) experience in utilization ...
Case Management
Livonia, MI · On-site
An Opportunity to Join our Remarkable Care as a Case Manager awaits YOU!!!! Trinity Health Livonia ... Five years of clinical experience in nursing and recent (within 2 year) experience in utilization ...
RN Case Manager
Owosso, MI · On-site
Prior Case Management or utilization review experience preferred. Case Management certification preferred. Essential Physical Requirements Must be able to sit or stand for long periods of time; be ...
RN Case Manager
Owosso, MI · On-site
Prior Case Management or utilization review experience preferred. Case Management certification preferred. Essential Physical Requirements Must be able to sit or stand for long periods of time; be ...
Case Manager-SW Afternoons
Detroit, MI · On-site
$19.75 - $25.50/hr
Knowledge of computers, Electronic Health Records, data base systems and utilization review/case management documentation systems. Desire to work collaboratively and proactively with healthcare teams ...
Case Manager-SW Afternoons
Detroit, MI · On-site
$19.75 - $25.50/hr
Knowledge of computers, Electronic Health Records, data base systems and utilization review/case management documentation systems. Desire to work collaboratively and proactively with healthcare teams ...
RN Case Manager
Owosso, MI · On-site
Prior Case Management or utilization review experience preferred. Case Management certification preferred. ESSENTIAL PHYSICAL REQUIREMENTS: Must be able to sit or stand for long periods of time; be ...
RN Case Manager
Owosso, MI · On-site
Prior Case Management or utilization review experience preferred. Case Management certification preferred. ESSENTIAL PHYSICAL REQUIREMENTS: Must be able to sit or stand for long periods of time; be ...
Utilization Case Manager information
What is a utilization case manager?
A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.
How does a utilization case manager typically collaborate with healthcare providers and insurance companies?
Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.
What degree do I need for utilization review?
Utilization case managers typically need at least a bachelor's degree in healthcare, nursing, social work, or a related field. Some positions may require a master's degree or professional certification, such as a Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ), to advance in the role or handle complex cases.
What are the key skills and qualifications needed to thrive as a utilization case manager?
To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.
What is the difference between Utilization Case Manager vs Utilization Review Nurse?
| Aspect | Utilization Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, case management certification | RN license, certification in utilization review |
| Work Environment | Case management teams, hospitals, insurance companies | Utilization review departments, hospitals, insurance providers |
| Primary Focus | Coordinating patient care, discharge planning, resource allocation | Assessing medical necessity, reviewing patient records for appropriateness |
| Common Usage | Broader case management roles, patient advocacy | Specific review of medical necessity and insurance claims |
While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.
What are popular job titles related to Utilization Case Manager jobs in Michigan?
For Utilization Case Manager jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Michigan look for?
The top searched job categories for Utilization Case Manager jobs in Michigan are:
What cities in Michigan are hiring for Utilization Case Manager jobs?
Cities in Michigan with the most Utilization Case Manager job openings:
Job description
13 week contractREQUIRED: 5+ years case management experience with 2+ years recent acute inpatient case management experience
BSN or MSW, Current MI RN licensure or LMSW, Discharge planning experience.
There will be limited training on site - candidates will need to be able to adapt quickly.
Manager will be reaching out to candidates directly for interview
MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.
About Teema
Sourced by ZipRecruiter
TEEMA is an award-winning, industry-leading recruitment agency dedicated to building meaningful relationships across North America. We achieve this time after time by consistently sourcing, screening, managing and securing top talent tailored to employers’ specific needs. The team that makes this happen consists of hundreds of experienced professional recruiters backed by exceptional, tenured leadership and back-office support. No matter how unique or challenging your hiring needs may be or how misunderstood or undervalued your in-demand skills may be in your current role, we have you covered. Our primary objective is to provide an exceptional recruitment experience for our clients and candidates and an ecosystem that empowers our team to thrive.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Litchfield Park, AZ, US