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Utilization Care Manager Jobs in Indiana (NOW HIRING)

... utilization, care planning quality, and facilitates discharge planning on admission and concurrent ... Certified Case Manager (CCM) preferred * 5 years of Nursing/Patient Care experience preferred * 2 ...

... Manager II is critical for working with assigned patients, including assessing, facilitating ... utilization, care planning quality, and facilitates discharge planning on admission and concurrent ...

... Manager II is critical for working with assigned patients, including assessing, facilitating ... utilization, care planning quality, and facilitates discharge planning on admission and concurrent ...

... Manager II is critical for working with assigned patients, including assessing, facilitating ... utilization, care planning quality, and facilitates discharge planning on admission and concurrent ...

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Manager of Utilization Management Brief Description of Duties: This position is reserved for a ... This individual's primary role is to ensure that health care services are administered with quality ...

RN Care Manager

Evansville, IN ยท On-site

$85K - $95K/yr

RN Care Manager - NO Weekends | M-F Schedule | Evansville, IN ๐Ÿ“ Evansville, IN | Full-Time | Day ... Perform utilization review (UR) and payer communication * Support hospital goals: reduce LOS ...

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Utilization Care Manager information

How does a Utilization Care Manager typically collaborate with medical and administrative teams to ensure effective patient care?

Utilization Care Managers work closely with physicians, nursing staff, and administrative teams to review patient cases, determine medical necessity, and coordinate appropriate care plans. They frequently participate in interdisciplinary meetings, communicate with insurance providers regarding authorizations, and ensure compliance with regulatory guidelines. This collaborative approach helps to optimize resource utilization, improve patient outcomes, and support smooth transitions of care. Being proactive in communication and documentation is key to success in this role.

What are Utilization Care Managers?

Utilization Care Managers are healthcare professionals responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They work to ensure that patients receive the right care at the right time, while also helping healthcare organizations manage costs and comply with regulations. Utilization Care Managers often review patient cases, coordinate with medical staff, and interact with insurance companies to authorize or deny services. Their goal is to optimize healthcare delivery, reduce unnecessary procedures, and improve patient outcomes.

What jobs pay 2000 a day?

Jobs that can pay $2,000 a day typically include specialized roles such as senior management, high-level consultants, certain medical professionals like surgeons, and experienced freelance contractors in fields like software development or engineering. These positions often require advanced skills, extensive experience, or professional certifications, and may involve project-based or contract work with high hourly or daily rates.

What does a utilization manager do in healthcare?

A utilization care manager in healthcare evaluates the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that care plans align with insurance policies and clinical guidelines to optimize resource use and control costs.

What are the key skills and qualifications needed to thrive as a Utilization Care Manager, and why are they important?

To thrive as a Utilization Care Manager, you need a background in healthcare, typically as a registered nurse or social worker, with expertise in care coordination and utilization review. Familiarity with utilization management software, medical necessity guidelines (such as Milliman or InterQual), and knowledge of insurance regulations are important. Strong analytical thinking, attention to detail, and effective communication skills help you advocate for patients while working with healthcare teams and payers. These skills ensure appropriate resource use, quality patient outcomes, and compliance with regulatory standards.

What is the highest paying job with a BSW?

The highest paying jobs with a Bachelor of Social Work (BSW) degree typically include roles such as clinical social worker, healthcare administrator, or mental health director, with salaries often exceeding $70,000 annually. Advancement to supervisory or administrative positions, along with additional certifications or experience, can lead to higher compensation in social services and healthcare settings.

What job makes $10,000 a month without a degree?

A Utilization Care Manager typically does not earn $10,000 a month without a degree, as this role usually requires healthcare or administrative certifications and experience. High-paying jobs that can reach this level without a degree often include specialized sales, real estate brokers, or skilled trades like certain construction or technical roles, but these usually require relevant skills, licenses, or extensive experience.

What is the difference between Utilization Care Manager vs Utilization Review Nurse?

AspectUtilization Care ManagerUtilization Review Nurse
CredentialsRN, case management certificationRN, certification in utilization review
Work EnvironmentHealthcare facilities, insurance companiesHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing resourcesReviewing medical necessity, approving treatments

Utilization Care Managers focus on coordinating patient care and managing resources, while Utilization Review Nurses primarily evaluate medical necessity for treatments. Both roles require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

What cities in Indiana are hiring for Utilization Care Manager jobs? Cities in Indiana with the most Utilization Care Manager job openings:
Inpatient Care Manager

Inpatient Care Manager

Franciscan Alliance

Indianapolis, IN โ€ข On-site

Other

Posted 5 days ago


Job description

Inpatient Care Manager II

The Inpatient Care Manager II is critical for working with assigned patients, including assessing, facilitating, planning, and advocating health needs on an individual basis. In this role you will perform admission screening for all patients in a bed for medical necessity, reviews for appropriateness of setting, utilization, care planning quality, and facilitates discharge planning on admission and concurrent basis.

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
  • Professional Development Opportunities
  • Faith-based, Mission-focused Organization
  • Assessing, facilitating, planning, and advocating health needs on an individual basis.
  • Performs admission screening for all patients in a bed for medical necessity, reviews for appropriateness of setting, utilization, care planning quality
  • Facilitates discharge planning on admission and concurrent basis
  • Full-time, occasional weekends
  • Shift times 8a-430p
Qualifications
  • A team-oriented RN willing to be flexible and dynamic in meeting patient care needs.
  • Associate Degree from an accredited program is required, BSN desirable
  • Licensed as a Registered Nurse (RN) with a valid license to practice in the state or as listed in the Nurse Licensure Compact (NLC)
  • 5 years RN experience required
  • 2 years Case Management preferred

Travel is required: Never or Rarely

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.