Utilization Case Manager Jobs in Detroit, MI (NOW HIRING)

Henry Ford Hospital - Detroit Main Campus

Dedicated to weekends - Saturday and Sunday 8 am - 6:30 pm

On site only.

GENERAL SUMMARY:

The Case Manager-RN plays a pivotal role in coordinating comprehensive patient care, ensuring seamless transitions between care levels. This position requires strong clinical judgment, excellent communication skills, and a deep understanding of healthcare systems. The Case Manager-RN will collaborate closely with patients, families, healthcare providers, and community resources to optimize patient outcomes and promote efficient resource utilization.

Orientation:

Monday through Friday 8 - 4:30 pm for 6 weeks and within those six weeks the new hire will need one weekend orientation consisting of onsite Sat/Sun 7:30-4pm. The new hire will get one day off during the week before Saturday worked, and one day off during the week after for the Sunday worked. It is a full-time during the 6-week orientation that may run a little longer to make sure the new hire is comfortable and able to perform the role independently. Weekends only include SAT and SUN, but there are current opportunities to pick up days.

Key Responsibilities:

Clinical Care Coordination:

• Conduct comprehensive patient assessments to identify individualized needs and develop personalized care plans.
• Collaborate with the healthcare team to ensure timely and appropriate interventions, including specialty consultations and referrals.
• Monitor patient progress, identify potential barriers to care, and implement strategies to address them proactively.
• Facilitate patient education and support to empower patients and families in their healthcare decisions.
• Develop and implement comprehensive discharge plans that address the patient's physical, social, and financial needs.
• Coordinate with community resources and post-acute care providers to ensure a smooth transition of care.
• Advocate for patients' rights and ensure access to necessary services and support.

Quality Improvement:

• Analyze patient outcomes and identify opportunities for improvement in care processes.
• Participate in quality improvement initiatives and contribute to the development of best practices.
• Stay updated on relevant regulations, guidelines, and industry trends to ensure compliance and optimize care delivery.

Interdisciplinary Collaboration:

• Collaborate effectively with physicians, nurses, social workers, therapists, and other healthcare professionals to deliver coordinated care.
• Facilitate communication and information sharing among team members to ensure optimal patient outcomes.
• Build strong relationships with community partners to support patient needs beyond the hospital setting.

By joining our team as a Case Manager-RN, you will have the opportunity to make a significant impact on the lives of patients and their families. Your expertise in clinical care, discharge planning, and quality improvement will be instrumental in ensuring that patients receive the highest quality care possible.

EDUCATION/EXPERIENCE REQUIRED:

Education:

• Bachelor's degree in Nursing (BSN) is preferred.
• Associate's degree in Nursing (ADN) with at least two years of acute care case management experience is acceptable.
• ADN candidates must enroll in an accredited BSN program within three years of hire and complete it within five years.

Experience:

• Minimum of three years of recent acute care nursing experience.
• Prior case management experience is highly preferred.

Certifications:

• Certification in Case Management (CCM) by the Commission for Case Management Certification or Accredited Case Manager (ACM) by the American Case Management Association is required within one year of hire.

Knowledge and Skills:

• Strong clinical knowledge and understanding of medical literature and research methodology.
• Familiarity with financial and reimbursement issues in healthcare.
• Excellent communication and interpersonal skills, including the ability to collaborate effectively with diverse teams.
• Strong organizational and time management skills.
• Proficiency with computers, electronic health records (EHR), database systems, and utilization review/case management documentation systems.
• Knowledge of CMS, commercial payer requirements, and hospital financial/reimbursement processes is desirable.
• Demonstrated ability to think critically, solve problems creatively, and plan effectively.
• Self-direction, flexibility, and the ability to work in a fast-paced environment.

Licenses and Certifications:

• Registered Nurse (RN) with a valid, unrestricted State of Michigan license.
• Adherence to Henry Ford Health's Customer Service Policy and standards.

Personal Qualities:

• Self-direction and commitment to teamwork.
• Initiative and willingness to learn.
• Openness to new experiences and respect for diversity.
• Demonstrated customer service values.

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Additional Information

• Organization: Henry Ford Hospital - Detroit Main Campus
• Shift: Day Job
• Union Code: Not Applicable

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .

The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.

Equal Employment Opportunity / Aff…

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.

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Henry Ford Hospital - Detroit Main Campus