MGR - UTILIZATION REVIEW / MGMT Job in Bloomington Meadows Hospital

Mgr Utilization Review / Mgmt

Bloomington, IN, US, United States

https://www.mncjobz.com/company/bloomington-meadows-hospital

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Job Description

Responsibilities:

The Utilization Management is responsible for executing the UM function, which includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients. Oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payers. Assures that good customer service practices are utilized. Maintains denials and appeals in Midas and reviews the progress of all appeal activity.
Qualifications:

Education: Bachelor's degree required.

Experience:Two (2) years direct clinical experience in a psychiatric or mental health treatment setting processing insurance coverage for patients preferred. Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities.

Licensure: Valid Indiana Registered Nursing or LSW preferred.

Hours of Work: May be required to work overtime and flexible hours.
Job Type: Full-time
Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Health insurance Life insurance Paid time off Tuition reimbursement Vision insurance

People with a criminal record are encouraged to apply
Experience:

Medical records: 1 year (Preferred)

Work Location: In person

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