Utilization Management Specialist — Care & Compliance

Universal Health Services; Plymouth (IN); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Competitive pay

Health benefits

401k plan

PTO generous

Life Insurance

Tuition support

Job summary

Universal Health Services' Michiana Behavioral Health in Indiana is seeking a full-time Utilization Management Specialist. This role handles calls, reviews, and medical necessity determinations with insurers, supporting discharge planning and data collection.

Candidates should have healthcare experience and an understanding of regulatory requirements. Responsibilities include admissions processing, concurrent reviews, data maintenance, and collaboration with Treatment Team meetings.

Qualifications

• Bachelor's degree in a related field is a plus.
• One to three years of healthcare experience required.
• Certification in Utilization Management a plus.
• Knowledge of regulatory and insurance required.
• Excellent documentation skills.
• Advocate for patient's rights and treatment.

Responsibilities

• Process admissions into the utilization management system.
• Conduct admission and concurrent reviews.
• Maintain statistics and data as requested/required.
• Attend Treatment Team meetings.
• Assists physicians with calls as needed.

Skills

Healthcare experience

Documentation skills

Patient advocacy

Regulatory knowledge

Communication skills

Education

Bachelor's degree in related field (a plus)

Certification in Utilization Management (a plus)

Job description

Universal Health Services' Michiana Behavioral Health in Indiana is seeking a full-time Utilization Management Specialist. This role handles calls, reviews, and medical necessity determinations with insurers, supporting discharge planning and data collection.

Candidates should have healthcare experience and an understanding of regulatory requirements. Responsibilities include admissions processing, concurrent reviews, data maintenance, and collaboration with Treatment Team meetings.