What are the responsibilities and job description for the Utilization Management position at Bloomington Meadows Hospital?
POSITION SUMMARY
The UM Manager is an experienced supervisor with at least three years of experience managing insurance denials in a healthcare setting. The UM Manager is responsible for ensuring insurance coverage for patients in the hospital. The UM Manager serves the Utilization Management department by effectively responding to insurance denials through collaboration with a multidisciplinary team of psychiatric healthcare professionals. The Utilization Manager strives to ensure that patient days (inpatient and outpatient) are covered and works to overturn insurance denials; assures that good customer service practices are utilized; maintains denials and appeals in Midas, and reviews the progress of all appeal activity. The UM Manager supervises three UM Coordinators.
QUALIFICATIONS
Education: Minimum three years of experience in UM; one year supervisory experience. Social work/medical education preferred.
Experience: Three years of experience supervising utilization management team in a healthcare setting (prefer psychiatric or mental health treatment setting) processing insurance coverage for patients. Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities.
Licensure: Preferred but not required (social work or nursing).
Hours of Work: Salaried position with flexibility in scheduling required.
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
Experience:
- Medical records: 1 year (Preferred)
Work Location: In person
Salary : $52,675 - $72,269