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Job Description
Responsibilities
The Utilization Management Specialist 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 : Diploma required. Associate or Bachelor Degree in Nursing or Social Work preferred.
Licensure : Valid Indiana Registered Nursing or LCSW preferred
Hours of Work : May be required to work overtime and flexible hours.
Last updated : 2024-04-25
Full Time
Hospital
$53k-70k (estimate)
02/24/2024
07/23/2024
bloomingtonmeadows.com
BLOOMINGTON, IN
200 - 500
1993
KURT ISACSON
$10M - $50M
Hospital
Bloomington Meadows Hospital is an environment dedicated to helping patients restore their health and get a fresh start. Providing each patient with comprehensive behavioral health treatment, our compassionate and caring staff are committed to the wellness of our patients, their families, and the communities that we serve. As a preferred provider of behavioral health care services, we deliver superior treatment that offers hope to start the journey of healing for our patients and their loved ones. Because we believe that each person is unique, all treatment plans are individually designed to m...eet each person's specific needs. The focus of treatment is practical and solution focused with an emphasis on symptom reduction and learning healthy coping skills. Treatment is inspired with a trauma informed philosophy, as well as collaboration with a variety of disciplines, which enables a comprehensive and multifaceted treatment approach.
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