POSITION SUMMARY

The UM Manager holds an Indiana RN license, a LSW, or similar applicable license-eligible graduate degree with a minimum three years of experience in Utilization Management 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 preventing 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. (One UM Coordinator position also available.)

QUALIFICATIONS

Education:

Master's degree or RN required.

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:

Valid Indiana Registered Nursing or LSW preferred.

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