UM, Case Manager

Havenwyck Hospital is a Joint Commission‑accredited and licensed psychiatric hospital, overlooking Lake Galloway in Auburn Hills, Michigan. We specialize in providing comprehensive, compassionate behavioral health services to children, adolescents, and adults. Our dedicated staff work toward building strength, confidence, and knowledge within each patient, in hopes that they may continue learning and understanding their needs and practicing self‑care for the rest of their lives. If you would like to learn more about this position before applying, please contact Havenwyck Hospital at View phone number on click.appcast.io. Position Summary The Utilization Management Case Manager has responsibility for organizing and conducting the care process. These duties support the hospital’s mission in the pursuit of excellence in care/service and include conducting timely admission and continuous stay record reviews with external payers, utilizing approved criteria to make determinations of medical necessity and level of care planning, verifying active treatment by completing internal audit reviews within approved time frames, assisting the treatment team when indicated in the discharge planning process, and acting as liaison with the MD/Clinical Treatment Team and external agencies. The role reports authorizations, denials, and documentation concerns and collaborates effectively across departments to minimize denials and facilitate optimal use of hospital resources. Duties and Responsibilities Use clinical skills and experience to report to external insurance and review entities an accurate presentation of the medical management of a patient’s illness, length of stay, and care alternatives available within the confines of the client’s benefits and financial resources. Communicate with the Treatment Team (physicians, nursing staff, social workers, etc.) as necessary to advocate for the patient’s clinical treatment within the confines of the client’s benefits and financial resources. Assist the team in ensuring the completeness and accuracy of the medical records using clinical skills and experience. Perform other related duties as assigned. Benefit Highlights Challenging and rewarding work environment Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision, and Prescription Drug Plan 401(K) with company match and discounted stock plan Career development opportunities within UHS and its 300+ subsidiaries Free Basic Life Insurance Tuition Reimbursement SoFi Student Loan Refinancing Program Student Loan Repayment Program – for some degrees and criteria Qualifications Bachelor’s Degree in social work, psychology, counseling, or nursing required. Master’s degree in social work, psychology, or counseling preferred. Limited or fully licensed (LBSW, RN, LLMSW, LLP, TLLP, LPC, LMFT, etc.). Minimum of 2 years of post‑graduate related experience in psychiatric or substance abuse treatment required. Hospital utilization review/utilization management experience preferred. Familiarity with the Medicare health care process, medical terminology, experience in case management, discharge planning, and/or utilization review preferred. Equal Employment Opportunity Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal‑opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion, and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status, or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. #J-18808-Ljbffr Havenwyck Hospital