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Utilization Manager in Indianapolis, IN

Centene Corp

Indianapolis, IN 46201
1w ago
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industry:

specialty:

Allied Health Professionals, Healthcare Management

experience:

Less than 5 years

Job Description

Description:

Position Purpose: Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial evaluations, brief focused treatment interventions, monitor quality of care, collect and analyze utilization and cost of care data, assist with discharge planning, arrange transportation; provide member assistance and participate in special utilization projects.


Authorize, direct and monitor care for mental health and substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care.

Ensure compliance with all performance measures in regards to appeals, denials, higher level of care admission certification and concurrent review timeliness, Outpatient Treatment Report review timeliness, readmissions, and others as indicated.

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Valid through: 2020-4-8

About Centene Corporation

Centene Corporation is a large publicly-traded company and a leading multi-line healthcare enterprise that serves as a major intermediary for both government-sponsored and privately-insured health care programs. The main lines of Centene include Medicare, Medicaid, The Health Insurance Marketplace System,, Tricare, as well as traditional commercial insurance. It is the second-largest publicly-traded corporation in the state of Missouri.
Total Jobs:
133
Total Experts:
27
Average Pay:
$121,583
Total value of jobs:
$29,180,000
% Masters:
44%
* Ladders Estimates