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)

P
Utilization Management Rep - Remote to Indiana
  • Professional Management Enterprises
  • Indianapolis, IN FULL_TIME
  • 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
  • 3 Days Ago

P
Behavioral Health Utilization Management Specialist - Remote in Indiana
  • Professional Management Enterprises
  • Indianapolis, IN FULL_TIME
  • DescriptionIdeal candidate will have Behavioral Health experience in a health care setting and or Utilization Review/ Case Management. This is a full-time position Sunday-Thursday 8am-5pm. The pay for...
  • 21 Days Ago

P
Utilization Review RN
  • Professional Management Enterprises
  • Indianapolis, IN FULL_TIME
  • Seeking a Registered Nurse with current in-state license, with Utilization review or quality management experience. This position is fully remote. Work schedule is Mon-Fri, 8:00am-5:00pm. Must have at...
  • 24 Days Ago

C
Nurse Director Case Management
  • Clinical Management Consultants
  • Valparaiso, IN FULL_TIME
  • An award-winning healthcare provider in Indiana is seeking a Nurse Director Case Management! This 100 bed community hospital has been serving residents of Northern Indiana for more than 40 years. They...
  • 11 Days Ago

L
Utilization Management Appeals Nurse - LPN/RN (Hybrid - Indianapolis, IN)
  • LPN/RN (Hybrid - Indianapolis, IN) - Acentra Health
  • Indianapolis, IN FULL_TIME
  • CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that de...
  • 11 Days Ago

H
Sorority House Director
  • House Director Professionals
  • Lafayette, IN CONTRACTOR,FULL_TIME
  • JOB SUMMARY: Phi Sigma Rho Sorority is seeking to place a full-time house director at Purdue University by August 1, 2024. The house director will be provided with a private bathroom, bedroom, and liv...
  • 1 Month Ago

P
Managing Director
  • Principal Financial Group
  • Miami, FL
  • Managing Director - Miami; Principal Financial Network 42364 Sales Regular Full-Time Miami, Florida No A048000-West Cent...
  • 6/11/2024 12:00:00 AM

D
Managing Director, Conflict Management & Dispute Resolution
  • Dallas College
  • Dallas, TX
  • Position Summary The Managing Director of Conflict Management & Dispute Resolution will be responsible for effectively d...
  • 6/10/2024 12:00:00 AM

S
Managing Director
  • Selby Jennings
  • Miami, FL
  • Are you passionate about driving impactful change in infrastructure and sustainability? Do you thrive in dynamic environ...
  • 6/10/2024 12:00:00 AM

E
Managing Director
  • Experis
  • Winston-Salem, NC
  • Build your career with Experis, a ManpowerGroup company as we connect human potential to the power of business. Through ...
  • 6/9/2024 12:00:00 AM

N
Managing Director
  • NEWMARK
  • Dallas, TX
  • Job Description Newmark (NMRK) is one of the world's leading commercial real estate advisory firms. We provide a fully i...
  • 6/9/2024 12:00:00 AM

O
Managing Director / Senior Managing Director - Debt Advisory
  • Oberon Securities, LLC
  • New York, NY
  • Oberon Securities, based in New York City, is seeking experienced Managing Directors with expertise raising asset, cash ...
  • 6/8/2024 12:00:00 AM

L
Managing Director Investment Management
  • Leadenhall Search & Selection
  • Leadenhall Search & Selection are currently recruiting for Directors and Partners on behalf of a global, fast-growing In...
  • 6/8/2024 12:00:00 AM

D
Senior Relationship Manager - Director - Managing Director
  • Deutsche Bank
  • Miami, FL
  • Job Description: Job Title Relationship Manager Corporate Title Director to Managing Director Location Miami, FL Overvie...
  • 6/7/2024 12:00:00 AM

Indiana /ˌɪndiˈænə/ (listen) is a U.S. state located in the Midwestern and Great Lakes regions of North America. Indiana is the 38th largest by area and the 17th most populous of the 50 United States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th U.S. state on December 11, 1816. Indiana borders Lake Michigan to the northwest, Michigan to the north, Ohio to the east, Kentucky to the south and southeast, and Illinois to the west. Before becoming a territory, various indigenous peoples and Native Americans inhabited Indiana for thousands of ye...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$123,319 to $166,753

Utilization Management Director in Abilene, TX
With an ever-increasing emphasis on reducing costs while still improving patient outcomes, utilization management is taking on new importance.
February 09, 2020
Utilization Management Director in Las Vegas, NV
Read more about the Humana Behavioral Health utilization management process and how it determines patient care.
February 18, 2020
Utilization Management Director in Boise, ID
Provides thought leadership on utilization initiatives and activities to enhance interdepartmental coordination.
December 19, 2019