Utilization Management Director jobs in Indiana
Utilization Management Director leads and directs the utilization review staff and function for a healthcare facility. Determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Being a Utilization Management Director manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. Provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Additionally, Utilization Management Director consults with physicians and other professionals to develop improved utilization of effective and appropriate services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). The Utilization Management Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Utilization Management Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Recently Added Utilization Management Director jobs
- Professional Management Enterprises
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Indianapolis, IN
FULL_TIME
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Description
We are looking for a utilization management representative to join our team. This position is a remote role but you must live in Indiana to be eligible. This role is Monday - Friday 8am- 5pm EST and the pay for this role is $18.00/hr.
- Responsible for coordinating cases for precertification and prior authorization review
- Managing incoming calls or incoming post services claims work.
- Determines contract and benefit eligibility
- Provides authorization for inpatient admission, outpatient certification, and post service requests
- Refers cases requiring clinical review to a nurse reviewer
- Responsible for the identification and data entry of referral requests into the UM system
- Responds to telephone and written inquiries from clients, providers and in-house departments
- Other duties as assigned
Requirements
Requires:
- HS Diploma/GED
- Minimum 1 year of customer service experience or call-center experience or any combination of education and experience
- Medical terminology training and experience in the medical or insurance field is preferred
- Needs to have strong oral, written and interpersonal communication skills, problem-solving skills, and analytical skills
- 15 Days Ago
- Pinnacle Treatment Centers
-
Merrillville, IN
FULL_TIME
- Utilization Management Specialist Working onsite at our Merrillville, IN treatment facility working collaboratively with the treatment team and health plans to obtain authorization for treatment We of...
- 19 Days Ago
- Pinnacle Treatment Centers
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Cambridge, IN
FULL_TIME
- Utilization Management Specialist Working onsite at our Cambridge City, IN treatment facility working collaboratively with the treatment team and health plans to obtain authorization for treatment We ...
- 19 Days Ago
- Humana
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Indianapolis, IN
FULL_TIME
- Become a part of our caring community and help us put health first Humana Healthy Horizons in Ohio is seeking a Utilization Management Administration Coordinator 2 who contributes to administration of...
- Just Posted
- Elevance Health
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Indianapolis, IN
FULL_TIME
- Job Family: CUS > Care Support Type: Full time Date Posted: Apr 22, 2024 Anticipated End Date: May 24, 2024 Reference: JR112960 Description Title: Utilization Management Representative I Location: Thi...
- 1 Day Ago
- McLaren Integrated HMO Group
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Indianapolis, IN
FULL_TIME
- About Us McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in ...
- 2 Days Ago
Utilization Management Director jobs at Popular Companies
- Oberon Securities Llc
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New York, NY
- Oberon Securities, based in New York City, is seeking experienced Managing Directors with expertise raising asset, cash ...
- 4/25/2024 12:00:00 AM
- Encompass Health
-
Altoona, PA
- The Facilities Management Director is responsible for ensuring that the company Rehabilitation Hospital, satellite clini...
- 4/25/2024 12:00:00 AM
- Oberon Securities, LLC
-
New York, NY
- Oberon Securities, based in New York City, is seeking experienced Managing Directors with expertise raising asset, cash ...
- 4/24/2024 12:00:00 AM
- Hunt Mh Shared Services Llc
-
Tulsa, OK
- Hunt MH Shared Services LLC Utility Management Director Seattle , Washington Apply Now DescriptionA Brief OverviewThe Ut...
- 4/24/2024 12:00:00 AM
- Principal Financial Services Inc.
-
Des Moines, IA
- What You'll DoWere looking for a Risk Management Director to join our Principal Asset Management team. In this role, you...
- 4/23/2024 12:00:00 AM
- Encompass Health
-
Mcdonough, GA
- The Facilities Management Director is responsible for ensuring that the company Rehabilitation Hospital, satellite clini...
- 4/23/2024 12:00:00 AM
- Hunt
-
Honolulu, HI
- A Brief Overview The Utility Management Director is responsible for providing leadership, direction and guidance as it p...
- 4/21/2024 12:00:00 AM
- Omnicom Media Group
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New York, NY
- Overview Job Description Annalect's 2,000+ innovators leverage data and technology to help clients across Omnicom build ...
- 4/21/2024 12:00:00 AM