Utilization Manager

Samaritan Daytop Village • Town of Wawarsing, NY

2d • Onsite

About The Position

In concert with the agency’s mission and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as needed with assuring compliance with external and internal utilization review/quality and appropriateness requirements.

Requirements

• High School Diploma or GED required
• Current CASAC or the ability to complete requirements to obtain a CASAC (T) within 6 months of hire
• At least one year of clinical or quality assurance experience in behavioral healthcare/human services organization or one year demonstrated clinical experience in substance use or mental health treatment
• In depth knowledge on HIPAA, OASAS, and 42 CFR regulations
• Working knowledge of quality assurance and utilization review systems
• Proficient in Microsoft Office Suite and EHR systems.
• Experience working with people from diverse racial, ethnic, and socioeconomic backgrounds.
• Strong written, verbal, and interpersonal communication skills.
• Ability to accurately document records according to program standards.
• Ability to work independently.

Nice To Haves

• higher education in the human services field, preferred
• Spanish bilingual skills are a plus.

Responsibilities

• Conducts timely scheduled/required utilization reviews for Residential Services sites.
• Conducts timely and complete quality and appropriateness reviews on a representative sample of treatment records for residential service sites.
• Attends monthly/other require UR Committee meetings. Prepares accurate and timely UR Committee minutes and reports. Participates in the agency’s Quality Improvement / Utilization Management Committee.
• Provides Supervisory support to CASAC Counselors and Peer Workers as needed with supervisory guidance from Management/Leadership Team.
• Monitors and evaluates ongoing audit for chart.
• Provides direct care services to clients as needed.
• Assists with the maintenance of the agency’s OASAS accreditation for the program, i.e., standards review and conformance auditing.
• Performs other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED