Work From Home Work From Home Work From Home, Indiana 46544 The Supervisor Utilization Management is responsible for the direct supervision of the daily operations of the Centralized Utilization ...
Work From Home Work From Home Work From Home, Indiana 46544 The Supervisor Utilization Management is responsible for the direct supervision of the daily operations of the Centralized Utilization ...
Utilization Management Nurse
Columbus, IN · On-site
... Director as needed to ensure proper medical necessity decisions are made in a timely manner ... management, utilization review, and medical necessity - Act and perform within the scope of ...
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Utilization Management Nurse
Columbus, IN · On-site
... Director as needed to ensure proper medical necessity decisions are made in a timely manner ... management, utilization review, and medical necessity - Act and perform within the scope of ...
... Utilization Management RN - HYBRI D , you'll provide care to our clients employees and their ... Manages the Site Accreditation Audit schedule as directed and collect, compile and report results.
... Utilization Management RN - HYBRI D , you'll provide care to our clients employees and their ... Manages the Site Accreditation Audit schedule as directed and collect, compile and report results.
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Reports to the Manager, Utilization Management Department. Serves as a liaison between Memorial ... Referring questionable medical necessity or extended stays to the Manager/Director, treating ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Reports to the Manager, Utilization Management Department. Serves as a liaison between Memorial ... Referring questionable medical necessity or extended stays to the Manager/Director, treating ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Reports to the Manager, Utilization Management Department. Serves as a liaison between Memorial ... Referring questionable medical necessity or extended stays to the Manager/Director, treating ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Reports to the Manager, Utilization Management Department. Serves as a liaison between Memorial ... Referring questionable medical necessity or extended stays to the Manager/Director, treating ...
Reports to the Manager, Utilization Management Department. Serves as a liaison between Memorial ... Referring questionable medical necessity or extended stays to the Manager/Director, treating ...
Reports to the Manager, Utilization Management Department. Serves as a liaison between Memorial ... Referring questionable medical necessity or extended stays to the Manager/Director, treating ...
As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...
As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...
... Director (and other management as appropriate) to identify and correct weaknesses in the admission ... Maintaining knowledge regarding current regulations (PRO, TJC, AHA, etc.) which impact utilization ...
... Director (and other management as appropriate) to identify and correct weaknesses in the admission ... Maintaining knowledge regarding current regulations (PRO, TJC, AHA, etc.) which impact utilization ...
... Director (and other management as appropriate) to identify and correct weaknesses in the admission ... Maintaining knowledge regarding current regulations (PRO, TJC, AHA, etc.) which impact utilization ...
... Director (and other management as appropriate) to identify and correct weaknesses in the admission ... Maintaining knowledge regarding current regulations (PRO, TJC, AHA, etc.) which impact utilization ...
... Director (and other management as appropriate) to identify and correct weaknesses in the admission ... Maintaining knowledge regarding current regulations (PRO, TJC, AHA, etc.) which impact utilization ...
... Director (and other management as appropriate) to identify and correct weaknesses in the admission ... Maintaining knowledge regarding current regulations (PRO, TJC, AHA, etc.) which impact utilization ...
Field Medical Director, Vascular Surgeon
Indianapolis, IN · On-site
$130 - $140/hr
As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
Field Medical Director, Vascular Surgeon
Indianapolis, IN · On-site
$130 - $140/hr
As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
... to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical leadership of all for utilization management, cost ...
... to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical leadership of all for utilization management, cost ...
Family Practice Physician Traditional Practitioner - Physicians Only Apply - Perm
Indianapolis, IN · On-site
... to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical leadership of all for utilization management, cost ...
Family Practice Physician Traditional Practitioner - Physicians Only Apply - Perm
Indianapolis, IN · On-site
... to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical leadership of all for utilization management, cost ...
Internal Medicine Physician General Internist - Physicians Only Apply - Perm
Indianapolis, IN · On-site
... to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical leadership of all for utilization management, cost ...
Internal Medicine Physician General Internist - Physicians Only Apply - Perm
Indianapolis, IN · On-site
... to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. * Provides medical leadership of all for utilization management, cost ...
As a Field Medical Director, MSK Surgery you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
As a Field Medical Director, MSK Surgery you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
Radiation Oncology Field Medical Director
Indianapolis, IN · On-site
$130 - $145/hr
Field Medical Director, Radiation Oncology As a FMD, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non ...
Radiation Oncology Field Medical Director
Indianapolis, IN · On-site
$130 - $145/hr
Field Medical Director, Radiation Oncology As a FMD, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non ...
Appeals Pharmacist (Remote)
Fort Wayne, IN · On-site
$52.25 - $63.75/hr
Collaborate with physicians, nurses, and medical directors during case reviews. * Track and report ... Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists ...
Appeals Pharmacist (Remote)
Fort Wayne, IN · On-site
$52.25 - $63.75/hr
Collaborate with physicians, nurses, and medical directors during case reviews. * Track and report ... Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists ...
Job Summary The Director, Care Management is responsible for overseeing the implementation ... Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ...
Job Summary The Director, Care Management is responsible for overseeing the implementation ... Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ...
... management, drug utilization review, clinical criteria configuration, and pharmacy system ... Builds collaborative relationships with pharmacy directors, clinical pharmacists, business analysts ...
... management, drug utilization review, clinical criteria configuration, and pharmacy system ... Builds collaborative relationships with pharmacy directors, clinical pharmacists, business analysts ...
Regional Medical Director-Indiana | Lead Clinical Performance, Value-Based Care & Strategic Health S
Indianapolis, IN · Remote
Position Summary The Regional Medical Director serves as the senior physician leader for a defined ... and utilization management. Health System & Community Partnership Development * Serve as the ...
Regional Medical Director-Indiana | Lead Clinical Performance, Value-Based Care & Strategic Health S
Indianapolis, IN · Remote
Position Summary The Regional Medical Director serves as the senior physician leader for a defined ... and utilization management. Health System & Community Partnership Development * Serve as the ...
Director Utilization Management information
What is a director utilization management?
A Director of Utilization Management oversees the review and approval of medical services to ensure they are necessary, efficient, and cost-effective. They develop strategies to improve care quality while managing healthcare costs, working closely with providers, payers, and regulatory bodies. Their responsibilities include policy development, compliance with healthcare regulations, and leading a team of utilization review professionals. This role is common in hospitals, insurance companies, and managed care organizations.
What are the typical daily responsibilities of a director utilization management?
A Director Utilization Management generally oversees a team responsible for reviewing patient care to ensure appropriate resource use and compliance with payer requirements. Daily tasks may include analyzing utilization data, developing policy and process improvements, collaborating with clinical and administrative staff, and addressing escalated cases or issues. Directors frequently attend strategy meetings, conduct staff training, and engage with external partners like insurance providers. This role requires balancing administrative oversight with hands-on problem solving to support both cost efficiency and quality patient care.
What are the key skills and qualifications needed to thrive in the director utilization management position, and why are they important?
To thrive as a Director Utilization Management, you need a strong background in healthcare administration, case management, and data-driven decision-making, often supported by a clinical degree and several years of management experience. Familiarity with utilization management software, electronic health records (EHRs), and certifications such as CCM or ACM are typically valued. Exceptional leadership, communication, and problem-solving skills distinguish top performers in this role. These competencies are vital for optimizing resource use, ensuring regulatory compliance, and leading teams to meet quality care standards.
What does a director of utilization management do?
A director of utilization management oversees the review and approval of healthcare services to ensure they are medically necessary and cost-effective. They develop policies, manage teams of reviewers, and collaborate with healthcare providers and insurance companies to optimize patient care and resource utilization.
What are the most commonly searched types of Utilization Management jobs in Indiana?
The most popular types of Utilization Management jobs in Indiana are:
What are popular job titles related to Director Utilization Management jobs in Indiana?
For Director Utilization Management jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Director Utilization Management jobs in Indiana look for?
The top searched job categories for Director Utilization Management jobs in Indiana are:
What cities in Indiana are hiring for Director Utilization Management jobs?
Cities in Indiana with the most Director Utilization Management job openings:
Full-time
Posted 6 days ago
Franciscan Health rating
6.8
Based on 272 frontline employees who took The Breakroom Quiz
499th of 896 rated healthcare providers
Job description
Work From HomeWork From Home Work From Home, Indiana 46544Up to 20%JOB RANGE:Supervisor Utilization Management: $82,347.20 - $113, 235.20INCENTIVE:Not Applicable
The Supervisor Utilization Management is responsible for the direct supervision of the daily operations of the Centralized Utilization Management department in order to assure that utilization management needs are addressed. This position ensures appropriate staffing levels, ongoing educational opportunities, and employee satisfaction to maintain operational commitment. The Supervisor maintains and enhances relationships with internal and external customers and peers across the continuum in order to facilitate excellent outcomes for patients and Franciscan.
WHO WE ARE
With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
Maintain inter- and intra-departmental communications, special projects, programs, policies, and procedures as well as care management services.
Participate and educate team in performance improvement initiatives. Implement processes to satisfaction with those we are privileged to serve.
Coordinate and maintain compliance with HFAP, state and federal agencies pertaining to Utilization/Denial management activities.
Supervise direct reports and manage the performance of individuals through ongoing coaching, feedback, and development to motivate, engage and drive a high performing team.
Make decisions for direct reports in assigned function and performs people management activities, such as, performance evaluations, disciplinary actions, staff planning, and interviews.
Supervise and maintain Utilization Management operations in collaboration with the Manager and Director, including ensuring appropriate utilization and denial management.
QUALIFICATIONS
Bachelor's Degree in Nursing required
Active Indiana Registered Nurse (RN) license required
5 years of Nursing/Patient Care required
2 years of Utilization or Case Management experience preferred
TRAVEL IS REQUIRED:
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on thebenefit section of our career site, jobs.franciscanhealth.org.
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