Experienced Caregiver PTO Offer

For the remainder of 2019, experienced caregivers will receive up to 24 hours of front-loaded paid time off, upon hire.
Ask your Community Health Network recruiter for details and qualifications.

Manager BHS Utilization Review

Job Ref
1907380
Category
Behavioral Health
Department
Admin-Gallahue Mental Health
Schedule
Full-time
Facility
Behavioral Health Admin

6930 Hillsdale Court
Indianapolis, IN 46250
United States

Shift
Day Job
Hours
Monday - Friday
8:00am - 5:00pm
Join our community
Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, “community” is still the heart of our organization.

It means providing our neighbors with the best care possible, backed by state-of-the-art technology.
It means getting involved in the communities we serve through volunteer opportunities and benefit initiatives.
It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields, and to better serve our patients.
And above all, it means exceptional care, simply delivered — and we couldn’t do it without you.

Job Duties
The Manager, Behavioral Health Services Utilization Review:
  • Develops and ensures the effective implementation of outpatient pre/re-certification process(es) for treatment services, Medicaid prior authorization process(es) with utilization review and continuous improvement.
  • Audits outpatient medical records for compliance with regulatory and payer documentation requirements, as well as on an as-needed-basis for special projects where audit data is essential.
  • Interfaces with and directs the clinical team and payer representatives to appropriate team members to assist in resolving problems in regard to insurance coverage.
  • Reports findings to appropriate behavioral care teams and Directors on a regular basis in regard to the teams’ performance on documentation deficiencies, as well as in regard to changes in or new regulatory or payer documentation requirements.
  • Reduces the risk of financial liability and the incidence of litigation through loss control prevention.
Your Qualifications
  • Three (3) to five (5) years experience in a behavioral health/substance use disorder setting.
  • Experience with Behavioral Health Utilization Review preferred.
  • Bachelors degree required, Masters degree preferred.
  • Management experience preferred.
Your Skills
  • Must have communication skills including oral, written, and in particular listening.
  • Ability to work independently and in a highly organized manner.
  • Ability to work in a team environment consisting of payer representative, physicians, therapists/clinicians, and co-workers.
  • Ability to work under pressure and balance competing demands of customers and projects.
  • Knowledge and understanding of systems of behavioral health utilization review, and computer skills.
Additional Information

Community Health Network embraces a servant leadership philosophy by putting the needs of patients, employees, and the community above their own. We strongly believe to provide exceptional healthcare services we need exceptional leaders. A Community leader humbly puts the needs of others first and provides focus and direction to those they have the privilege of leading. They demonstrate compassion in all interactions and are deeply invested in the growth and development of others. 

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