MGR - UTILIZATION REVIEW / MGMT
 Universal Health Services | |
dental insurance, life insurance, vision insurance, paid time off, tuition reimbursement, 401(k)
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 United States, Indiana, Bloomington | |
| 3600 North Prow Road (Show on map) | |
 Oct 19, 2025 | |
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Responsibilities
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:
People with a criminal record are encouraged to apply Experience:
Work Location: In person | |