Up to 10% of posts at a Nottingham NHS trust are at risk as part of plans to save £1.7m, it has been confirmed.
NHS Nottingham City is launching a 30-day consultation with its 285 staff about how to reduce management costs, which may lead to 28 posts being cut.
Bosses said savings had to be made this year to ensure resources were invested into front-line health care services.
But it has also warned further savings in its annual £570m budget will be needed in future.
NHS Nottingham City chief executive Andrew Kenworthy said: "NHS Nottingham City is committed to improving the health and well being of local people.
"In order to do this we are looking to make sure we are investing all we can in front-line services by reducing administration and management costs.
"We are working with local health organisations and other partners across the city to continue to drive up standards for patient safety, experience and outcomes."
Corall Jenkins, regional organiser for Unison, said: "Unison accepts that savings have to be made but want to keep jobs losses to a minimum.
"Therefore we will be putting together alternative savings plans during the consultation which will avoid job cuts as much as possible."
A trust spokesman said other measures, such as limiting use of consultants and a jobs freeze, were already in place.
NHS Nottingham City organises patient care in the area and buys in services from other parts of the NHS.