Utilization Management Director jobs in Indianapolis, IN

Utilization Management Director leads and directs the utilization review staff and function for a healthcare facility. Determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Being a Utilization Management Director manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. Provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Additionally, Utilization Management Director consults with physicians and other professionals to develop improved utilization of effective and appropriate services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). The Utilization Management Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Utilization Management Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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Utilization Management Rep - Remote to Indiana
  • Professional Management Enterprises
  • Indianapolis, IN FULL_TIME
  • Description

    We are looking for a utilization management representative to join our team. This position is a remote role but you must live in Indiana to be eligible. This role is Monday - Friday 8am- 5pm EST and the pay for this role is $18.00/hr.


    • Responsible for coordinating cases for precertification and prior authorization review
    • Managing incoming calls or incoming post services claims work.
    • Determines contract and benefit eligibility
    • Provides authorization for inpatient admission, outpatient certification, and post service requests
    • Refers cases requiring clinical review to a nurse reviewer
    • Responsible for the identification and data entry of referral requests into the UM system 
    •  Responds to telephone and written inquiries from clients, providers and in-house departments
    • Other duties as assigned

    Requirements

    Requires:

    • HS Diploma/GED
    • Minimum 1 year of customer service experience or call-center experience or any combination of education and experience
    • Medical terminology training and experience in the medical or insurance field is preferred
    • Needs to have strong oral, written and interpersonal communication skills, problem-solving skills, and analytical skills
  • 16 Days Ago

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Utilization Management Administration Coordinator
  • Humana
  • Indianapolis, IN FULL_TIME
  • Become a part of our caring community and help us put health first Humana Healthy Horizons in Ohio is seeking a Utilization Management Administration Coordinator 2 who contributes to administration of...
  • Just Posted

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Utilization Management Representative I
  • Elevance Health
  • Indianapolis, IN FULL_TIME
  • Job Family: CUS > Care Support Type: Full time Date Posted: Apr 22, 2024 Anticipated End Date: May 24, 2024 Reference: JR112960 Description Title: Utilization Management Representative I Location: Thi...
  • 2 Days Ago

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Utilization Management, RN, IN - Remote
  • McLaren Integrated HMO Group
  • Indianapolis, IN FULL_TIME
  • About Us McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in ...
  • 3 Days Ago

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Behavioral Health Utilization Management Specialist - Remote in Indiana
  • Professional Management Enterprises
  • Indianapolis, IN FULL_TIME
  • DescriptionIdeal candidate will have Behavioral Health experience in a health care setting and or Utilization Review/ Case Management. This is a full-time position Sunday-Thursday 8am-5pm. The pay for...
  • 1 Month Ago

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Utilization Review RN Care Manager II
  • Professional Management Enterprises
  • Indianapolis, IN FULL_TIME
  • A Medical RN Care Manager II is needed to meet HBR targets and member enrollment. Fully remote M-F 8AM - 5PM. MUST reside in the state of Indiana.Cold call outreach to members,Completion of member mul...
  • 15 Days Ago

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0 Utilization Management Director jobs found in Indianapolis, IN area

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Dual Event Operations Coordinator
  • White Lodging
  • Indianapolis, IN
  • Summary: The Event Coordinator provides support and assistance for Event Managers in the planning and execution of event...
  • 4/26/2024 12:00:00 AM

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Quality Director Construction Management
  • AECOM
  • Indianapolis, IN
  • Company Description Work with Us. Change the World. At AECOM, we're delivering a better world. Whether improving your co...
  • 4/25/2024 12:00:00 AM

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2024-25 Managing Director of ELA Achievement
  • Kipp Indy Public Schools
  • Indianapolis, IN
  • Job Description Job Description Company DescriptionKIPP the largest nonprofit network of college-preparatory, public cha...
  • 4/24/2024 12:00:00 AM

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HR - Human Resources Generalist (0-5 years experience)
  • FPC - FORTUNE PERSONNEL CONSULTANTS (Orlando Office)
  • Indianapolis, IN
  • HUMAN RESOURCES GENERALIST 0-5 years experience HR Management & Administration Manufacturing Plant Environment (Non-Unio...
  • 4/24/2024 12:00:00 AM

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HR - Human Resources Generalist (0-5 years experience)
  • FPC - FORTUNE PERSONNEL CONSULTANTS (Orlando Office)
  • Plainfield, IN
  • HUMAN RESOURCES GENERALIST 0-5 years experience HR Management & Administration Manufacturing Plant Environment (Non-Unio...
  • 4/24/2024 12:00:00 AM

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Audit Managing Director | Commercial Services
  • Careerarc
  • Indianapolis, IN
  • Title: Audit Managing Director | Commercial ServicesDescription: **Company Profile:**At FORVIS, your career is designed ...
  • 4/23/2024 12:00:00 AM

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Manager
  • FORD'S GARAGE 01070
  • Noblesville, IN
  • Reports to: General Manager/Director of Operations/Executive VP Operations JOB SUMMARY: Our mission is to provide an inn...
  • 4/23/2024 12:00:00 AM

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Business Development Manager
  • YASH Technologies
  • Indianapolis, IN
  • Business Development / Sales Managers / Directors (Various Roles and Locations) YASH Technologies is hiring multiple ful...
  • 4/22/2024 12:00:00 AM

Indianapolis is in the East North Central region of the Midwestern United States, in central Indiana. According to the U.S. Census Bureau, the Indianapolis (balance) encompasses a total area of 368.2 square miles (954 km2), of which 361.5 square miles (936 km2) is land and 6.7 square miles (17 km2) is water. The consolidated city boundaries are coterminous with Marion County, with the exception of the autonomous municipalities of Beech Grove, Lawrence, Southport, and Speedway. Indianapolis is the 16th largest city by land area in the U.S. Indianapolis is within the Tipton Till Plain, a flat to...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$123,146 to $166,518
Indianapolis, Indiana area prices
were up 1.3% from a year ago

Utilization Management Director in Johnstown, PA
Prior authorization decisions are also made using Medical Management and Behavioral Health Care Management internally derived policies and procedures developed using evidence-based guidelines based on national, state and locally established standards of practice.
March 01, 2020
Utilization Management Director in Carson City, NV
The utilization management coordinator must have strong project management skills to implement various programs within the allocated budget and set time limits.
January 31, 2020
Utilization Management Director in Melbourne, FL
Develops and administers polices and procedures for utilization control of inpatient and outside referral services countywide and for in a variety of categorical programs including the Medically Indigent Adult (MIA) Program.
January 08, 2020