Utilization Manager
About The Position
The Utilization Manager will coordinate Utilization Management functions for the agency. This role involves training staff on proper documentation, including assessments, treatment planning, progress notes, and transition/discharge plans. The manager will provide feedback to staff on meeting service guidelines, fidelity review, and licensure requirements. Additionally, they will train staff on submitting Registration, Authorization, and Discharge requests, perform Utilization Management reviews, and coordinate the resolution of pended authorizations. The role also includes tracking service utilization and compliance with contractual requirements, assisting with external audits, developing and implementing corrective action plans, and completing regular testing of the electronic medical record functionality.
Requirements
- Licensed as LCSW, LPC, LMSW, or LAPC
- Ability to communicate effectively, both orally and in writing.
- Ability to train others
Responsibilities
- Trains staff on proper documentation, including assessments, treatment planning, progress notes, transition/discharge plans
- Provides feedback to staff regarding changes needed in order to meet service guidelines, fidelity review, and licensure requirements
- Trains staff on proper submission of Registration, Authorization and Discharge requests
- Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations
- Tracks utilization of services and compliance with contractual requirements
- Assists in the coordination of external audits
- Develops and implements any corrective action plans needed
- Completes regular testing of the electronic medical record functionality
Benefits
- Paid vacation days that increase with tenure
- Separate sick leave that rolls over each year
- Up to 10 Paid holidays
- Medical, Dental, Vision benefit plan options
- Employee Assistance Program
- Health, Dependent and Transportation Flexible Spending Accounts
- Employee, Spouse and Dependent Basic and Optional Life Insurance
- 401 K Plan
- Mileage & Cell Phone Reimbursement (or company phone)
- Pet Insurance
- DailyPay- daily access to your earnings without waiting for payday!
- SoFi at Work student loan refinancing
- Next Steps Financial Wellness program webinars and tools
- Company laptop and great IT support
- Verizon discount
- Dell discount
- Perks at Pathways national discounts on travel, shopping, and entertainment
- Training, Development and Continuing Education Credits for licensure requirements
- Opportunities for advancement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
