Healthcare Utilization & QA Lead

Samaritan Daytop Village, Inc.; Town of Wawarsing (NY); On-site; USD 70,000 - 78,000; Full time

Job summary

Samaritan Daytop Village, Inc. is seeking an Utilization Manager to support CASAC counselors and supervise staff while ensuring compliance with utilization review and quality requirements.

You will participate in quality improvement efforts, coordinate reviews, and assist with accreditation activities in a busy behavioral health setting. The role emphasizes timely chart reviews, staff support, and adherence to HIPAA, OASAS, and 42 CFR regulations, with opportunities to contribute to program

Qualifications

• High School Diploma or GED required; higher education in human services preferred.
• Current CASAC or ability to obtain CASAC (T) within 6 months of hire.
• At least one year of clinical or quality assurance experience in behavioral healthcare.
• Knowledge of HIPAA, OASAS, and 42 CFR regulations.
• Proficient in Microsoft Office and EHR systems.
• Spanish bilingual skills are a plus.
• Ability to work independently.

Responsibilities

• Conducts timely scheduled utilization reviews for Residential Services sites.
• Performs quality and appropriateness reviews on treatment records for residential sites.
• Attends UR Committee meetings; prepares minutes and reports; participates in QI/UM Committee.
• Provides supervisory support to CASAC Counselors and Peer Workers as needed.
• Monitors and evaluates ongoing chart audits.
• Provides direct care services to clients as needed.
• Assists with OASAS accreditation, standards review, and conformance auditing.
• Performs other duties as assigned.

Skills

CASAC

Quality Assurance

Documentation

Communication skills

Spanish (bonus)

Regulatory knowledge

Microsoft Office

EHR systems

Independence

Education

High School Diploma or GED

Higher education in human services

Tools

Microsoft Office Suite

EHR systems

Job description

Samaritan Daytop Village, Inc. is seeking an Utilization Manager to support CASAC counselors and supervise staff while ensuring compliance with utilization review and quality requirements.

You will participate in quality improvement efforts, coordinate reviews, and assist with accreditation activities in a busy behavioral health setting. The role emphasizes timely chart reviews, staff support, and adherence to HIPAA, OASAS, and 42 CFR regulations, with opportunities to contribute to program