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Mgr Utilization Review Job Opening In Granger – Now Hiring Beacon Health System


Job description

Summary

The Manager of Utilization Review is responsible for overseeing the utilization review process to ensure the appropriate, efficient, and cost-effective use of healthcare resources.

This role supports clinical and financial outcomes by coordinating with medical staff, case managers, and payors, and by implementing strategies that align with Beacon Health System’s mission and regulatory requirements.

MISSION, VALUES and SERVICE GOALS 

  • MISSION: We deliver outstanding care, inspire health, and connect with heart.

  • VALUES: Trust.

    Respect.

    Integrity.

    Compassion.

  • SERVICE GOALS: Personally connect.

    Keep everyone informed.

    Be on their team.

  • Leadership & Oversight 

  • Lead and mentor a team of Utilization Review Nurses.

  • Develop and implement utilization management protocols and strategies.

  • Ensure compliance with Medicare, Medicaid, and third-party payor requirements.

  • Collaborate with the Director of Case Management to align departmental goals.

  • Utilization review Operations 

  • Monitor medical necessity of admissions, duration of stays, and services rendered.

  • Address authorization challenges and reduce preventable denials.

  • Maintain accurate documentation of all Utilization Review activities.

  • Performance Improvement 

  • Analyze utilization data to identify inefficiencies and opportunities for cost savings.

  • Implement LEAN methodologies to improve Utilization Review processes.

  • Prepare reports for oversight committees and leadership.

  • Education & Staff Development 

  • Assess learning needs and develop orientation and continuing education programs.

  • Validate staff competencies through audits and direct observation.

  • Serve as a resource for complex Utilization Review decision-making.

  • Compliance & Quality Assurance 

  • Ensure adherence to medical necessity criteria – Xsolis, MCG, and InterQual guidelines.

  • Support quality improvement initiatives in collaboration with the Quality team.

  • Maintain up-to-date knowledge of healthcare regulations and technologies.

  • ORGANIZATIONAL RESPONSIBILITIES 

    Associate complies with the following organizational requirements: 

  • Attends and participates in departmental meetings and is accountable for shared information.

  • Completes mandatory education, competencies, and department-specific training within required timeframes.

  • Meets annual employee health and licensure/certification requirements.

  • Maintains required certifications, such as BCLS/CPR, as applicable.

  • Uses universal precautions, protective equipment, and ergonomic techniques appropriately.

  • Adheres to regulatory, compliance, and survey requirements.

  • Complies with organizational and departmental policies and is available to work flexible schedules and overtime as needed.

  •  

    Commitment to Beacon's six-point Operating System, referred to as The Beacon Way: 

  • Leverage innovation everywhere.

  • Cultivate human talent.

  • Embrace performance improvement.

  • Build greatness through accountability.

  • Use information to improve and advance.

  • Communicate clearly and continuously.

  • Leadership Competencies

  • Drives Results - Consistently achieving results, even under tough circumstances.
  • Customer Focus - Building strong customer relationships and delivering customer-centric solutions.
  • Instills Trust - Gaining the confidence and trust of others through honesty, integrity, and authenticity.
  • Collaborates - Building partnerships and working collaboratively with others to meet shared objectives.
  • Communicates Effectively - Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences.
  • Education and Experience 

  • Bachelor’s Degree in Nursing required; Master’s in Nursing, Healthcare Administration, or related field preferred.

  • Current RN license in the state of Indiana.

  • Minimum 3–5 years of experience in utilization review or case management.

  • Prior supervisory or management experience strongly preferred.

  • Skills & Competencies 

  • Strong analytical and critical-thinking skills.

  • Excellent communication and interpersonal abilities.

  • Proficiency in healthcare software and electronic health records.

  • Knowledge of reimbursement methodologies.

  • Ability to lead change and foster a culture of continuous improvement.

  • Working Conditions

  • Works in an office environment
  • Physical Demands

  • Requires the physical ability and stamina to perform the essential functions of the position.
  • Required Skill Profession

    Other Management Occupations


    • Job Details

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    Unlock Your Mgr Utilization Potential: Insight & Career Growth Guide


    Real-time Mgr Utilization Jobs Trends (Graphical Representation)

    Explore profound insights with Expertini's real-time, in-depth analysis, showcased through the graph here. Uncover the dynamic job market trends for Mgr Utilization in Granger, United States, highlighting market share and opportunities for professionals in Mgr Utilization roles.

    9829 Jobs in United States
    9829
    1 Jobs in Granger
    1
    Download Mgr Utilization Jobs Trends in Granger and United States

    Are You Looking for Mgr Utilization Review Job?

    Great news! is currently hiring and seeking a Mgr Utilization Review to join their team. Feel free to download the job details.

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    The Work Culture

    An organization's rules and standards set how people should be treated in the office and how different situations should be handled. The work culture at Beacon Health System adheres to the cultural norms as outlined by Expertini.

    The fundamental ethical values are:

    1. Independence

    2. Loyalty

    3. Impartiapty

    4. Integrity

    5. Accountabipty

    6. Respect for human rights

    7. Obeying United States laws and regulations

    What Is the Average Salary Range for Mgr Utilization Review Positions?

    The average salary range for a varies, but the pay scale is rated "Standard" in Granger. Salary levels may vary depending on your industry, experience, and skills. It's essential to research and negotiate effectively. We advise reading the full job specification before proceeding with the application to understand the salary package.

    What Are the Key Qualifications for Mgr Utilization Review?

    Key qualifications for Mgr Utilization Review typically include Other Management Occupations and a list of qualifications and expertise as mentioned in the job specification. The generic skills are mostly outlined by the . Be sure to check the specific job listing for detailed requirements and qualifications.

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    Interview Tips for Mgr Utilization Review Job Success

    Beacon Health System interview tips for Mgr Utilization Review

    Here are some tips to help you prepare for and ace your Mgr Utilization Review job interview:

    Before the Interview:

    Research: Learn about the Beacon Health System's mission, values, products, and the specific job requirements and get further information about

    Other Openings

    Practice: Prepare answers to common interview questions and rehearse using the STAR method (Situation, Task, Action, Result) to showcase your skills and experiences.

    Dress Professionally: Choose attire appropriate for the company culture.

    Prepare Questions: Show your interest by having thoughtful questions for the interviewer.

    Plan Your Commute: Allow ample time to arrive on time and avoid feeling rushed.

    During the Interview:

    Be Punctual: Arrive on time to demonstrate professionalism and respect.

    Make a Great First Impression: Greet the interviewer with a handshake, smile, and eye contact.

    Confidence and Enthusiasm: Project a positive attitude and show your genuine interest in the opportunity.

    Answer Thoughtfully: Listen carefully, take a moment to formulate clear and concise responses. Highlight relevant skills and experiences using the STAR method.

    Ask Prepared Questions: Demonstrate curiosity and engagement with the role and company.

    Follow Up: Send a thank-you email to the interviewer within 24 hours.

    Additional Tips:

    Be Yourself: Let your personality shine through while maintaining professionalism.

    Be Honest: Don't exaggerate your skills or experience.

    Be Positive: Focus on your strengths and accomplishments.

    Body Language: Maintain good posture, avoid fidgeting, and make eye contact.

    Turn Off Phone: Avoid distractions during the interview.

    Final Thought:

    To prepare for your Mgr Utilization Review interview at Beacon Health System, research the company, understand the job requirements, and practice common interview questions.

    Highlight your leadership skills, achievements, and strategic thinking abilities. Be prepared to discuss your experience with HR, including your approach to meeting targets as a team player. Additionally, review the Beacon Health System's products or services and be prepared to discuss how you can contribute to their success.

    By following these tips, you can increase your chances of making a positive impression and landing the job!

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