Begin a fulfilling career with the State of Indiana by joining one of the largest employers in the state, offering a range of opportunities across 60+ agencies. At the state, you'll find competitive compensation, a robust benefits package, and a commitment to work-life balance. Most importantly, you'll have the chance to make a real and measurable impact on the lives of Hoosiers across Indiana.
About the Family & Social Services Administration (FSSA): FSSA was established by the Indiana General Assembly in 1991 to consolidate and better integrate the delivery of human services by state government. FSSA is a health care and social services funding agency. Ninety-four percent of the agency's total budget is paid to thousands of service providers ranging from major medical centers to a physical therapist working with a child or adult with a developmental disability. The seven care divisions in FSSA administer services to more than 1.5 million Hoosiers. FSSA's mission is to compassionately serve Hoosiers of all ages and connect them with social services, health care, and their communities.
The role of Utilization Management Manager oversees the integration of utilization review, clinically appropriate care, and risk management for the purpose of quality assurance in Indiana Medicaid. In this role, you will ensure Indiana Medicaid members achieve positive health outcomes through access to high quality care and services. You serve as the utilization management subject-matter expert in health care delivery, develops utilization management reporting requirements for all Medicaid programs, including managed care and analyzes and evaluates the reporting to determine impact on members and providers as well as Managed Care Entities (MCE) performance. In this role, you are responsible for understanding the landscape of health care delivery for vulnerable populations and utilizes this knowledge in developing partnerships to ensure high-level of quality in Medicaid programs. Travel is required. This role provides direct supervision for one or more staff members.
The ideal candidate for this role will have a bachelor's degree in nursing, public administration, public policy, public health or related program that provides the skills needed to conduct oversight of all utilization management practices and clinical criteria evaluations. They will possess a current unrestricted RN license from the State of Indiana; a minimum of three (3) years of experience in healthcare and utilization management plus a minimum of three (3) years of staff management and evaluation experience; clinical experience in managed care and accredited utilization management experience strongly preferred. This candidate will also possess a strong data and information technology skillset to ensure best practices in collecting and analyzing data.
The salary for this position traditionally starts at $75,010 annually but may be commensurate with education or work experience.
The essential functions of this role are as follows:
The ideal candidate in this role should minimally have either + a Master's Degree and 7+ years of experience, + or a Bachelor's Degree and 9+ years of experience, or + an Associate's Degree and 11+ years of experience, or + at least 13+ years of experience applying the below, outlined knowledge, skills, and abilities in a similar role. You must meet the following requirements to be considered for employment:
This role may provide direct supervision for one or more staff members.
The State of Indiana offers a comprehensive benefit package for full-time employees which includes:
The State of Indiana is an Equal Opportunity Employer and is committed to recruiting, selecting, developing, and promoting employees based on individual ability and job performance. Reasonable accommodations may be available to enable individuals with disabilities to complete the application and interview process as well as perform the essential functions of a role. If you require reasonable accommodations to complete this application, you can request assistance by contacting the Indiana State Personnel Department at jobs@spd.IN.gov.