What are the responsibilities and job description for the MGR - UTILIZATION REVIEW / MGMT position at Universal Health Services, Inc.?
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