Utilization Management Specialist - Healthcare Data & Care

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

Benefits offered by this job

Challenging environment

Career development

Competitive pay

Health plan

401(k) match

Paid time off

Life insurance

Tuition reimbursement

Job summary

Michiana Behavioral Health, part of UHS, seeks a dedicated Utilization Management Specialist to manage calls, perform reviews, and support discharge planning and data collection. This full-time role focuses on coordinating with insurers, external reviewers, and internal teams to ensure compliant utilization management.

The ideal candidate will have a related bachelor's degree, 1–3 years in healthcare, knowledge of regulatory requirements, and strong documentation skills to advocate for patient

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 requirements.
• Excellent documentation skills.
• Advocate for patient's rights and treatment.

Responsibilities

• The Utilization Management Specialist handles calls, investigations and clinical reviews with insurance companies, managed care entities and external reviewers.
• Provides assistance to discharge planning, statistical collection and general departmental support.
• Process admissions into the utilization management system.
• Conduct admission and concurrent reviews.
• Maintain statistics and data as requested.
• Attend Treatment Team meetings and assist physicians with calls as needed.

Skills

Excellent documentation skills

Advocate for patient's rights and care

Knowledge of regulatory and insurance

Education

Bachelor's degree in related field

Tools

Certification in Utilization Management

Job description

Michiana Behavioral Health, part of UHS, seeks a dedicated Utilization Management Specialist to manage calls, perform reviews, and support discharge planning and data collection. This full-time role focuses on coordinating with insurers, external reviewers, and internal teams to ensure compliant utilization management.

The ideal candidate will have a related bachelor's degree, 1–3 years in healthcare, knowledge of regulatory requirements, and strong documentation skills to advocate for patient