MGR - UTILIZATION REVIEW / MGMT

Universal Health Services, Inc.; Bloomington (IN); On-site; USD 100,000 - 140,000; Full time

Job summary

Universal Health Services, Inc. is seeking an experienced Utilization Management Manager to lead the hospital's utilization management program. The role includes oversight of utilization review, case documentation, payer relationships, and regulatory compliance, with emphasis on patient outcomes and reimbursement optimization.

The position requires in-person work, staff development, and departmental administration to support hospital operations and regulatory adherence.

Qualifications

• Must have RN license or Master's degree.
• 5–7 years in acute inpatient psychiatric setting as a treatment team member, or 3–5 years in utilization management for mental health and substance use disorders.
• Work Location: In person

Responsibilities

• Oversee utilization reviews, case documentation, and payer relationships.
• Ensure regulatory compliance, staff management, and department administration.

Skills

RN license

Master's degree

Education

Registered Nurse license

Master's Degree

Job description

The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement.

Responsibilities

The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement.

Qualifications

QUALIFICATIONS

• Education :Must have Registered Nurse license or Master's Degree.
• Experience: 5-7 yrs acute inpatient psychiatric setting as a treatment team member experience or 3-5 years of experience in utilization management for both mental health and substance abuse behavioral health disorders experience.
• Work Location: In person