Utilization Management Specialist: Healthcare Reviews

Aiken Regional Medical Centers; Plymouth (IN); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Challenging environment

Career development

Competitive compensation

Medical/Dental/Vision plan

401(k) with match

Paid Time Off

Life Insurance

Tuition reimbursement

Job summary

Michiana Behavioral Health, a UHS facility, is seeking an Utilization Management Specialist to manage calls, perform investigations, and conduct clinical reviews with insurers and external reviewers. The role supports discharge planning and data collection, contributing to efficient department operations.

You will process admissions, perform concurrent reviews, maintain statistics, attend Treatment Team meetings, and assist physicians as needed, contributing to high-quality, compliant patient

Qualifications

• 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

Regulatory knowledge

Documentation skills

Patient advocacy

Utilization Management knowledge

Education

Bachelor's degree in a related field

Job description

Michiana Behavioral Health, a UHS facility, is seeking an Utilization Management Specialist to manage calls, perform investigations, and conduct clinical reviews with insurers and external reviewers. The role supports discharge planning and data collection, contributing to efficient department operations.

You will process admissions, perform concurrent reviews, maintain statistics, attend Treatment Team meetings, and assist physicians as needed, contributing to high-quality, compliant patient