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.
...the fastest-growing, full-service commercial real estate services... ...market knowledge and development opportunities to succeed. When... ...seeking a dynamic and strategic Director of Business Development to lead growth... ...acquisitions, and property management goals. The ideal candidate...
...according to their needs. Enters, processes, and verifies City arrest reports, arraignment dockets, surety and cash bonds, juvenile citations,... ...; removes arrest warrants from appropriate cases. Attends court and ensures accurate court documents. Operates office equipment...
...between large Earth observation models and specific application developers, enabling intuitive interaction with geospatial data. Our core... ...Required Technical Skills Frontend Expertise: Deep experience with React, including component architecture, state management...
...Job Details: Software Developer C# C++ We are seeking a Software Developer to design, build, and maintain software applications for cutting-edge technologies. This role involves UI development, backend programming, and software validation in a fast-paced, collaborative...
...pathogens, sparks, flames, high consequence infectious diseases (HCID), and many toxic chemicals. International Enviroguard is seeking an experienced and motivated Regional Sales Manager who specializes in Safety, Industrial, Medical and Construction sales. They will...