Director Utilization Management
UHS•Plymouth, IN
•Onsite
About The Position
The Director of Utilization Management is responsible for directing and overseeing the UM Dept, which includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients. This position also oversees the response to requests for services and interfaces with managed care organizations, external case managers, and other payers. Also, assures that good customer service practices are utilized. Maintains denials and appeals logs and reviews the progress of all appeals activity on a monthly basis.
Requirements
- Registered Nurse licensed in the State of Indiana or a Master level clinician required.
- 8 - 10 years of experience working in an acute inpatient psychiatric setting as a treatment team member or 5 -7 years of experience in utilization management for both mental health and substance abuse behavioral health disorders.
Nice To Haves
- Masters degree is a related field preferred.
- Licensed Master level clinician preferred.
Responsibilities
- Oversee all utilization management functions.
- Oversee precertification, concurrent, and discharge utilization reviews.
- Facilitates regulatory compliance with proper documentation.
- Oversees Utilization Management committee structure.
- Develops and monitors utilization management plans.
Benefits
- Challenging and rewarding work environment
- Career development opportunities within UHS and its Subsidiaries
- Competitive Compensation
- Excellent Medical, Dental, Vision and Prescription Drug Plan
- 401(K) with company match and discounted stock plan
- Generous Paid Time Off
- Free Basic Life Insurance
- Tuition Reimbursement
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What This Job Offers
Job Type
Full-time
Career Level
Director
