Utilization Manager

Samaritan Daytop Village; Town of Wawarsing (NY); On-site; USD 49,194 - 55,696; Full time

Job summary

Samaritan Daytop Village in Wawarsing, New York, is looking for a Utilization Manager to support quality care delivery in residential services. Responsibilities include conducting utilization reviews, supporting CASAC Counselors, and attending UR Committee meetings.

The ideal candidate should have a high school diploma or GED, a year of relevant clinical experience, and knowledge of HIPAA regulations. Strong communication skills and proficiency in EHR systems are essential for success.

Qualifications

• High School Diploma or GED required.
• Current CASAC or ability to obtain a CASAC (T) within 6 months.
• At least one year of clinical or quality assurance experience.

Responsibilities

• Conduct timely utilization reviews for Residential Services.
• Attend UR Committee meetings and prepare minutes.
• Monitor and evaluate auditing for charts.

Skills

Clinical experience

Quality assurance knowledge

Communication skills

Microsoft Office Suite proficiency

Bilingual (Spanish)

Education

High School Diploma or GED

Higher education in human services

Tools

EHR systems

Job description

Overview

Utilization Manager

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

Monday-Friday 9am-5pm

$35.71 - $40.43 per hour

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.