Utilization 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

Overview

Utilization Manager

Healthcare staff can work anywhere….The BEST work with US!

A nationally recognized comprehensive Health and Human Services Agency, with over 60 programs across New York City and greater New York Area.

Samaritan Daytop Village, serves over 33,000 New Yorkers annually within your neighborhoods and communities so our success depends on those we employ.

The Role

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.

Responsibilities

What You Will Do

• 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.

Qualifications

Who You Will Be

• High School Diploma or GED required, higher education in the human services field, preferred
• 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.
• Spanish bilingual skills are a plus.

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