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.
...through life's journey Position Summary: The Graphic Production Specialist creates engaging and impactful design solutions... ...other production tasks as needed. Select colors, artwork, photography, type style, and other visual elements for the design within...
...physical world with digital precision, starting with retail and expanding far beyond! ABOUT THE JOB We are looking for a Machine Learning Engineer to help build and develop our ML capabilities at RADAR. The role requires extensive collaboration with teams and functions...
...Job Description: Call Center Bilingual Collections Representative (English/Spanish) - Hybrid This full-time fluent Bilingual... ...be able to report to this location to work in center 3-4 days weekly and remotely from home 1-2 days weekly. This is your...
...and freezers inspected each of your shifts to ensure it is clean, and all pastry related items are put away properly Be aware of food cost by effectively scaling ingredients, minimizing waste, and preventing theft Monitor equipment and ensuring all specialized pastry...
Class B Ready-Mix Driver JobLooking for reliable Class B driver to operate a brand new ready-mix truck out of Franktown, CO. Ready-Mix experience is a plus. Will be responsible for delivering ready mix concrete to customer job sites. Must have a clean driving record...