Healthcare Utilization & QA Manager

Samaritan Daytop Village, Inc.; Northern (KY); Hybrid; USD 70,000 - 95,000; Full time

Job summary

Samaritan Daytop Village, Inc. is seeking an Utilization Manager in New York to support CASAC Counselors and supervisory staff while ensuring compliance with external and internal utilization review, quality, and appropriateness requirements for residential services.

The role includes participating in UR Committee meetings, preparing accurate minutes and reports, and providing supervisory guidance. Proficiency in MS Office and EHR, with HIPAA and regulatory knowledge, is essential.

Qualifications

• Requires High School Diploma or GED; higher human services education preferred.
• Must possess CASAC or be able to obtain CASAC (T) within 6 months of hire.
• At least one year of clinical or QA experience in behavioral health or substance use treatment; knowledge of HIPAA, OASAS, and 42 CFR regulations.

Responsibilities

• Conducts timely utilization reviews for Residential Services sites.
• Performs quality and appropriateness reviews on treatment records.
• Attends UR Committee meetings and prepares minutes and reports.
• Provides supervisory support to CASAC Counselors and Peer Workers.
• Monitors and evaluates ongoing chart audits.
• Provides direct care services as needed.
• Maintains OASAS accreditation readiness through standards review and conformance auditing.

Skills

HIPAA knowledge

Quality assurance

Documentation

Microsoft Office

EHR systems

Bilingual Spanish a plus

Independent work

Education

High School Diploma or GED

CASAC certification or ability to obtain within 6 months

Tools

Microsoft Office Suite

EHR systems

Job description

Samaritan Daytop Village, Inc. is seeking an Utilization Manager in New York to support CASAC Counselors and supervisory staff while ensuring compliance with external and internal utilization review, quality, and appropriateness requirements for residential services.

The role includes participating in UR Committee meetings, preparing accurate minutes and reports, and providing supervisory guidance. Proficiency in MS Office and EHR, with HIPAA and regulatory knowledge, is essential.