Utilization Manager

Samaritan Daytop Village•Queens, NY

8d•$35 - $38•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

OASAS CASAC Certification (with Bachelor’s Degree); OR Other QHP credential such as LMSW, LMHC, LMSW-LP, or MHC-LP (with Master’s Degree).
Bachelor’s Degree in Human Services; AND OASAS CASAC certification; OR Master’s Degree in Social Work or related field; AND Other QHP credential such as LMSW, LMHC, LMSW-LP, or MHC-LP.
At least One (1) year clinical or quality assurance experience in behavioral healthcare/human services organization or One (1) 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.
Computer literacy including proficiency in Microsoft Office Suite and EHR.
Experience working directly with people from diverse racial, ethnic, and socioeconomic backgrounds.
Competency in written, interpersonal, verbal, and computational skills to present and document records in accordance with program standards.
Ability to work independently.

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.