Utilization Review Manager - Home Care jobs in Indiana
Utilization Review Manager - Home Care ensures quality and level of care for patients are up to established standards and comply with federal, state, and local regulations. Investigates and resolves reports of inappropriate care. Being a Utilization Review Manager - Home Care may require a bachelor's degree. Typically reports to a head of a unit/department. To be a Utilization Review Manager - Home Care typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)
Recently Added Utilization Review Manager - Home Care jobs
- Professional Management Enterprises
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Indianapolis, IN
FULL_TIME
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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 multiple enrollment and follow-up assessments,
- Creation of member care plans
- Input documentation into multiple computer systems
- Daily collaboration with CM/UM/Pharmacy peers to meet member needs
- Checking eligibility in FSSA system,
- Research claim encounter and Hospital systems to obtain member health history
- Maintain Case Load 50
- Daily outreach 20-40 calls daily
- Monthly Quality Audit score 90%
Education/Experience:
Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2 years of clinical nursing experience in a clinical, acute care, or community setting and 1 years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.
Licenses/Certifications: Current state’s RN license. - 7 Days Ago
- Monroe Hospital
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Bloomington, IN
FULL_TIME
- Overview: At Monroe Hospital, our dedicated team of professionals is committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system in th...
- 11 Days Ago
- Adams Health Network
-
Decatur, IN
FULL_TIME
- The PCS Case Manager/Utilization Review Nurse (UR) is responsible for monitoring and justifying the acute level of care according to criteria established by State and Federal regulatory agencies, insu...
- 5 Days Ago
- Franciscan Health
-
Mishawaka, IN
FULL_TIME
- Work From Home Work From Home Work From Home, Indiana 46544 WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care sy...
- 1 Day Ago
- Sycamore Springs
-
Lafayette, IN
FULL_TIME
- Overview Sycamore Springs *Fully In-Person Role* Utilization Review Specialist Full Time, Monday-Friday Members of our team Enjoy: Working with a highly engaged staff Healthy staffing levels Flexible ...
- 4 Days Ago
- Springstone, Inc.
-
Lafayette, IN
FULL_TIME
- Overview Sycamore Springs *Fully In-Person Role* Utilization Review Specialist Full Time, Monday-Friday Members of our team Enjoy: Working with a highly engaged staff Healthy staffing levels Flexible ...
- 5 Days Ago
Utilization Review Manager - Home Care jobs at Popular Companies
- Insight Global
-
- We recognize that our success depends on the quality of the people we hire. We are currently seeking highly talented ind...
- 4/18/2024 12:00:00 AM
- Providence Health & Services
-
Hesperia, CA
- Under the direction of the Utilization Supervisor/ Manager, this position is responsible for the distribution, review, a...
- 4/18/2024 12:00:00 AM
- City of Upland, CA
-
Upland, CA
- Salary : $124,287.53 - $158,625.88 Annually Location : Public Works - 1370 N. Benson Ave Upland, CA Job Type: Full Time ...
- 4/17/2024 12:00:00 AM
- AMI Network
-
San Diego, CA
- I’m partnered with a major health plan in San Diego to find a Director of Utilization Management! This top-rated Medicai...
- 4/17/2024 12:00:00 AM
- Dsj Global
-
Saint Louis, MO
- We are seeking a highly skilled and experienced Utility Manager to oversee the operation and maintenance of utility syst...
- 4/16/2024 12:00:00 AM
- Medasource
-
Fresno, CA
- Job Title: Interim Case Management Manager Client: Large Healthcare Provider Location: Fresno, California Start Date: AS...
- 4/16/2024 12:00:00 AM
- Medasource
-
Fresno, CA
- Job Title: Utilization Management Manager Location: Fresno, California (travel reimbursement if needed) Start Date: ASAP...
- 4/16/2024 12:00:00 AM
- DSJ Global
-
St Louis, MO
- We are seeking a highly skilled and experienced Utility Manager to oversee the operation and maintenance of utility syst...
- 4/14/2024 12:00:00 AM