The Utilization Management Specialist is responsible for executing the UM function, which includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients. Oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payers. Assures that good customer service practices are utilized. Maintains denials and appeals in Midas and reviews the progress of all appeal activity.
QualificationsEducation: Diploma required. Associate or Bachelor Degree in Nursing or Social Work preferred.
Experience: Two (2) years direct clinical experience in a psychiatric or mental health treatment setting preferred. Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities.
Licensure: Valid Indiana Registered Nursing or LCSW preferred
Hours of Work: May be required to work overtime and flexible hours.
DescriptionJoin a leading milling operation in Kings burg as a Maintenance Mechanic. Youll play a key role in maintaining and repairing production equipment to ensure smooth, safe, and efficient operations acrossour facility.Location:Kingsburg, CA Pay:$22.00$2...
Offering Daily Pay for select positions Addus HomeCare is hiring immediately for Home Care Aides. This rewarding, entry-level position provides consistent, flexible full-time/part-time hours to accommodate your personal needs while providing a great career with a growing...
Germain of LouisvilleAudi, Porsche, Land RoverAutomotive Office Manager/ControllerLouisville, KY Pay based on experience At Germain, our mission is to attract, develop and retain exceptional people to deliver an outstanding experience that creates...
...and enjoy an energetic atmosphere alongside your coworkers.This position is great for teens looking for their first job, and seasoned bakers alike. Whats in it for you? Flexible Schedule Growth Opportunities Employee Discounts (more cookies, please!!)...
...Duties: The Department of Operations and Information Management (OIM) at the Wisconsin... ...collaboration, and increased student and educational opportunities, RISE addresses complex... ...Systems, Operations Research, Management Science or related field required by start date...