Registered Nurse (RN) - Case Management

Company: Detroit Medical Center
Location: Detroit
Posted on: July 5, 2025

Job Description:

Job Description Detroit Medical Center is seeking a Registered Nurse (RN) Case Management for a nursing job in Detroit, Michigan. Job Description & Requirements - Specialty: Case Management - Discipline: RN - Duration: Ongoing - 36 hours per week - Shift: 12 hours - Employment Type: Staff /n Children’s Hospital of Michigan is an international leader in pediatric and adolescent medicine. Surgical services include general, thoracic, reconstructive and cardiovascular. Imaging technology designed specifically for children provides advanced diagnostic services including Positron Emission Tomography (PET) and MRI. The Children’s Hospital of Michigan Emergency Department is a verified Level 1 Pediatric Trauma Center and dedicated pediatric burn center. Experts in pediatric critical care, rehabilitation, and neonatal and perinatal medicine provide care for thousands of children every year at Children’s Hospital of Michigan, Children’s Hospital of Michigan - Troy and six ambulatory sites. SUMMARY: The Group Director Case Management is responsible for executing Tenet's organizational case management strategic plan across multiple hospitals. They are a leader, mentor, consultant, and subject matter expert regarding case management regulations and standards. The individual in this position has overall responsibility for hospital utilization management, transition management and operational management of the Case Management Department in order to promote effective utilization of hospital resources, timely and accurate revenue cycle processes, denial prevention, safe and timely patient throughput, and compliance with all state and federal regulations related to case management services. This position integrates national standards for case management scope of services including: · Lead and facilitate group hospital Directors of Case Management performance for Level of Care, Length of Stay, and Payer Authorizations · Establish goals and objectives that support overall strategic plans of the Case Management and Utilization Review strategy · Lead Group hospital Case Management and Utilization Review operations for cost-effective and clinically sound care delivery including the Tenet Case Management model, staffing and skill mix, complex Case Management, and centralized utilization review · Participate in new hospital Director of Case Management selection and lead the orientation and onboarding processes · Maintain objectivity in decision making, utilizes facts to support decisions · Anticipate and responds to problems and risks · Communicate effectively with all levels in the organization and with internal / external customers · Direct, support, and coach direct reports · Develop “experts” and “expertise” throughout the department and seeks employee input · Minimize staff turnover · Lead implementation and monitoring of Tenet Case Management policy and regulatory requirements · Review weekly Case Management Scorecard Continuing Care (CC) and Utilization Review (UR) metrics, Observed / Expected Length of Stay, Authorizations and Downgrades · Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement · Manage department operations to ensure effective throughput and reimbursement for services provided · Ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet policy · Ensure timely and effective patient transition and planning to support efficient patient throughput · Implement and monitor processes to prevent payer disputes · Develop and provide physician education and feedback on hospital utilization · Participate in management of post-acute provider network · Ensure compliance with state and federal regulations and TJC accreditation standards Qualifications: QUALIFICATIONS: Required: Bachelor’s degree in business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW. Preferred: Advanced degree in business, nursing and/or healthcare administration, health science or related discipline. Required: Five (5) years of acute hospital case management or healthcare leadership experience. Preferred: Multi-site hospital case management leadership experience, business planning and project management experience preferred. Required: Registered Nurse or LCSW/LMSW license. Must be currently licensed, certified, or registered to practice profession as required by law or regulation in state of practice or policy. Active RN or LCSW/LMSW license for state(s) covered. Preferred: Accredited Case Manager (ACM) PHYSICAL DEMANDS: -Lift/position up to 25 lbs. Push/pull up to 25 lbs of force. -Frequent sitting. Moderate standing, walking, reaching, stooping, and bending -Manual dexterity, mobility, touch, auditory to perform all the related duties of the position Job: Managers and Directors Primary Location: Detroit, Michigan Facility: DMC Children's Hospital of Michigan Job Type: Full Time Shift Type: Day Detroit Medical Center Job ID 4369-2506001359-2. Posted job title: Group Director of Case Management About Detroit Medical Center The Detroit Medical Center (DMC) is the leading academically–integrated hospital system in Metro Detroit, and one of the largest health care providers in Southeast Michigan. During our 150 years of caring for the community, we have been recognized nationally with top awards in many aspects of hospital operations and patient care. The DMC is able to achieve these awards because of our exceptional employees. The Detroit Medical Center is one the largest academic medical centers in the United States, with a long and rich history of medical education, for more than 100 years. We train more physicians than any other hospital in Detroit. Our evidence-based approach inspires confidence and spurs innovation. It ensures that we are making treatment decisions based on our experience, on the best available research and our understanding of each patient as an individual. Our commitment to our patients Our commitment to patient care and improving patient outcomes is part of everything we do. It’s our mission. It’s our promise to every patient and every family who entrusts their care to us. To meet the needs of our community, we operate 8 hospitals and more than 140 clinics and outpatient facilities across southeast Michigan, including a nationally recognized dedicated pediatric hospital (Children’s Hospital of Michigan) as well as a nationally recognized rehabilitation hospital (Rehabilitation Institute of Michigan). We offer an inclusive, diverse and supportive environment. Knowing that we are better together, our teams are highly collaborative and integrated to deliver the high quality and compassionate care our patients expect and deserve. Staff members have a voice in forming our culture; one that is often referred to as “my forever family” and “colleagues who have my back”. The DMC has a proud legacy of caring for the people and the families that call Metro Detroit home; they’re our neighbors, our friends, and our community. That’s why the DMC serves everyone in the community who needs us; no one gets turned away who comes to us for care. From local food drives to our long-standing commitment to educate and empower our community towards better health, you can count on the DMC. There’s a spirit of caring and togetherness that you will experience when you join the DMC family. We are a community build on care. At the DMC, we are committed to maintaining an environment of Equal Opportunity and Affirmative Action. If you need a reasonable accommodation to access the information provided on this web site, please contact the DMC facility where the position is available, for further assistance. 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 status as an individual disability. Employee Benefits At the DMC, health and well-being are important to us, so we provide a range of benefits and options to help meet the needs of all eligible employees. In addition to a range of healthcare plans, including higher and lower deductible options, we offer dental, vision and an employee assistance plan. Basic life insurance and Accidental Death and Dismemberment insurance are provided for free to eligible plan members. Employees can also choose to participate in one of several supplemental life insurance and/or disability plans, a legal services plan and an identity protection plan. For those employees who are looking for support to care for family members, we also offer child and elder care programs. To help employees prepare for retirement, we offer a 401K savings plan, and an employee discount plan that includes discounts for a wide variety of products, including auto and home insurance and mobile plans. Benefits - Medical benefits - Dental benefits - Vision benefits - Employee assistance programs - Life insurance - Discount program

Keywords: Detroit Medical Center, Detroit , Registered Nurse (RN) - Case Management, Healthcare , Detroit, Michigan