Access-Utilization Manager
Port Huron, MI ยท On-site
... staff meetings Assist with developing and implementing regional Utilization Management Program Plan Provide lead clinical support and participation on Region 10 committees (UMC, IPLT, SERC ...
Port Huron, MI ยท On-site
... staff meetings Assist with developing and implementing regional Utilization Management Program Plan Provide lead clinical support and participation on Region 10 committees (UMC, IPLT, SERC ...
Port Huron, MI ยท On-site
... staff meetings Assist with developing and implementing regional Utilization Management Program Plan Provide lead clinical support and participation on Region 10 committees (UMC, IPLT, SERC ...
Troy, MI ยท On-site
... assist with Denial Letters Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team. Identifies ...
Troy, MI ยท On-site
... assist with Denial Letters Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team. Identifies ...
... assist with Denial Letters Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team. Identifies ...
... assist with Denial Letters Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team. Identifies ...
$33 - $37/hr
... assist with Denial Letters * Provides concurrent review and prior authorizations (as needed) according to policy for members as part of the Utilization Management team. * Identifies appropriate ...
$33 - $37/hr
... assist with Denial Letters * Provides concurrent review and prior authorizations (as needed) according to policy for members as part of the Utilization Management team. * Identifies appropriate ...
The primary focuses of the position include: 1. Utilization Management Review Services: Using BCBA ... assist in clinical services. The UMBA works as part of an interdisciplinary team and is expected to ...
The primary focuses of the position include: 1. Utilization Management Review Services: Using BCBA ... assist in clinical services. The UMBA works as part of an interdisciplinary team and is expected to ...
The primary focuses of the position include: 1. Utilization Management Review Services: Using BCBA ... assist in clinical services. The UMBA works as part of an interdisciplinary team and is expected to ...
The primary focuses of the position include: 1. Utilization Management Review Services: Using BCBA ... assist in clinical services. The UMBA works as part of an interdisciplinary team and is expected to ...
Grand Rapids, MI ยท On-site
DRG assignment * Assist with case mix index (CMI) improvement initiatives * Review complex cases for documentation opportunities that accurately reflect patient acuity Utilization Management & Length ...
Grand Rapids, MI ยท On-site
DRG assignment * Assist with case mix index (CMI) improvement initiatives * Review complex cases for documentation opportunities that accurately reflect patient acuity Utilization Management & Length ...
Dewitt, MI ยท On-site
$13.50 - $18.25/hr
Summary: This position supports the Utilization Management (UM) workflows by providing ... Assists with coordinating Grievance and Appeals requests. * Assist with all Blue Card Claims ...
Dewitt, MI ยท On-site
$13.50 - $18.25/hr
Summary: This position supports the Utilization Management (UM) workflows by providing ... Assists with coordinating Grievance and Appeals requests. * Assist with all Blue Card Claims ...
Grand Rapids, MI ยท On-site
DRG assignment * Assist with case mix index (CMI) improvement initiatives * Review complex cases for documentation opportunities that accurately reflect patient acuity Utilization Management & Length ...
Grand Rapids, MI ยท On-site
DRG assignment * Assist with case mix index (CMI) improvement initiatives * Review complex cases for documentation opportunities that accurately reflect patient acuity Utilization Management & Length ...
Dewitt, MI ยท On-site
$13.50 - $18.25/hr
Summary: This position supports the Utilization Management (UM) workflows by providing ... Assists with coordinating Grievance and Appeals requests. * Assist with all Blue Card Claims ...
Dewitt, MI ยท On-site
$13.50 - $18.25/hr
Summary: This position supports the Utilization Management (UM) workflows by providing ... Assists with coordinating Grievance and Appeals requests. * Assist with all Blue Card Claims ...
Troy, MI ยท On-site
... Utilization reviews and assist with Denial Letters Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management ...
Troy, MI ยท On-site
... Utilization reviews and assist with Denial Letters Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management ...
Almont, MI ยท On-site
$20.07 - $28.59/hr
The Care Management Assistant is a patient-focused role that manages and optimizes patient care in ... with care managers, utilization review RNs, revenue cycle, and payers as needed to coordinate ...
Almont, MI ยท On-site
$20.07 - $28.59/hr
The Care Management Assistant is a patient-focused role that manages and optimizes patient care in ... with care managers, utilization review RNs, revenue cycle, and payers as needed to coordinate ...
The Lead Utilization Management (UM) Case Manager has responsibility for daily case assignments to ... assist in the timely filing of claims, which, in turn, facilitates the accurate and appropriate ...
The Lead Utilization Management (UM) Case Manager has responsibility for daily case assignments to ... assist in the timely filing of claims, which, in turn, facilitates the accurate and appropriate ...
The Lead Utilization Management (UM) Case Manager has responsibility for daily case assignments to ... assist in the timely filing of claims, which, in turn, facilitates the accurate and appropriate ...
The Lead Utilization Management (UM) Case Manager has responsibility for daily case assignments to ... assist in the timely filing of claims, which, in turn, facilitates the accurate and appropriate ...
... utilization management-related activities and functions to ensure that appropriate data are tracked, evaluated, and reported including Important Message from Medicare (IMM) and Medicare Outpatient ...
... utilization management-related activities and functions to ensure that appropriate data are tracked, evaluated, and reported including Important Message from Medicare (IMM) and Medicare Outpatient ...
... utilization management-related activities and functions to ensure that appropriate data are tracked, evaluated, and reported including Important Message from Medicare (IMM) and Medicare Outpatient ...
... utilization management-related activities and functions to ensure that appropriate data are tracked, evaluated, and reported including Important Message from Medicare (IMM) and Medicare Outpatient ...
Bachelor's degree in coding/medical records/billing or UM Two years of case management or utilization review experience Three years of recent experience doing third party payer certification ...
Bachelor's degree in coding/medical records/billing or UM Two years of case management or utilization review experience Three years of recent experience doing third party payer certification ...
Detroit, MI ยท On-site
Perform Peer-to-Peer calls for inpatient and post-acute care denials * Assist with length of stay management and utilization of resources * Review and make suggestions related to resource and service ...
Detroit, MI ยท On-site
Perform Peer-to-Peer calls for inpatient and post-acute care denials * Assist with length of stay management and utilization of resources * Review and make suggestions related to resource and service ...
Perform Peer-to-Peer calls for inpatient and post-acute care denials * Assist with length of stay management and utilization of resources * Review and make suggestions related to resource and service ...
Perform Peer-to-Peer calls for inpatient and post-acute care denials * Assist with length of stay management and utilization of resources * Review and make suggestions related to resource and service ...
Perform Peer-to-Peer calls for inpatient and post-acute care denials * Assist with length of stay management and utilization of resources * Review and make suggestions related to resource and service ...
Perform Peer-to-Peer calls for inpatient and post-acute care denials * Assist with length of stay management and utilization of resources * Review and make suggestions related to resource and service ...
$25.3K - $28.5K
1% of jobs
$28.5K - $31.7K
4% of jobs
$31.7K - $34.9K
7% of jobs
$37.1K is the 25th percentile. Wages below this are outliers.
$34.9K - $38.1K
18% of jobs
The median wage is $40.4K / yr.
$38.1K - $41.3K
27% of jobs
$43.4K is the 75th percentile. Wages above this are outliers.
$41.3K - $44.5K
28% of jobs
$44.5K - $47.7K
7% of jobs
$47.7K - $50.9K
3% of jobs
$50.9K - $54.2K
2% of jobs
$54.2K - $57.4K
1% of jobs
$57.4K - $60.6K
1% of jobs
$25.3K
$42.2K
$60.6K

The Access-UM Manager position is a program and administrative management position providing operational oversight and direction for behavioral health services utilization across the region respective to the Region 10 PIHP Access Unit and Utilization Management Unit. An employee at this level is required to perform, among others, the following essential duties:
Provide oversight of Access-UM clinical operations, including backup to the Lead Clinician and clinical staff
Provide direction and supervision of all Access-UM clinical staff and program support staff
Monitor and ensure daily staff coverage, including on-call after-hours coverage
Ensure completion of Access Management System reports
Provide oversight of regional Utilization Management (UM) and Utilization Review (UR) activities across the CMH and SUD provider networks, including case finding and case record review, protocol updates, and quarterly and end of year activity reports
Assist in the development and periodic evaluation of regional clinical practice guidelines
Facilitate and support provider network implementation and sustainment activities pertaining to MDHHS evidence-based practices and UM/UR guidance documents
Complete staff performance reviews and staff development plans
Develop Access-UM Staff Meeting Agenda and conduct staff meetings
Assist with developing and implementing regional Utilization Management Program Plan
Provide lead clinical support and participation on Region 10 committees (UMC, IPLT, SERC), including backup to the UMC Chair
Participate on other committees and work groups as assigned
Provide SME input and representation on HSAG audit Standards and contract monitoring
Serve as backup to the CCO on the state-wide UM Directors Group
Provide technical guidance on clinical issues related to regional Credentialing and Privileging policy standards and Grievance and Appeal reviews and policy standards
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Public administration
11 - 50 Employees
Port Huron, MI, US
2014