The Utilization Manager (UM) is responsible for the authorization, quality and organization of services providing to clients. These standards are met by analyzing documents, charts and files, systemizing operational procedures and monitoring the delivery of services. The Utilization Manager ensures all clients are provided complete services based on comprehensive assessments, a proper diagnosis, and the careful development of individual service plans.
1. Conduct quality examination of all documented services to ensure proper treatment is being provided to each client. The reviewing of medical and clinical records includes, but is not limited to Assessments, Psych Evaluations, Individual Service Plans and Progress Notes. Conclude with evidence of the reviews by writing and/or signing Orders for Services to authorize clients for treatment as needed.
2. Review notes on a weekly basis to ensure accurate service codes, units and clinical rational for service rendered and assist individual staff in improving their treatment plan and progress note writing skills as needed.
3. Conduct quality assurance on the Agency’s assessment/treatment planning tool to assure it meets the external auditing Agency requirements.
4. Assist in maintaining the department files, records and charts. Conduct scheduled and systemized weekly chart audits and monthly billing audits.
5. Process and submit cases for authorization, reauthorization and discharges. Input and review data as needed to ensure the timely authorization of cases.
Job Type: Contract
Medical specialties:
Schedule:
- Day shift
- Monday to Friday
Experience:
- Clinical Assessment: 1 year (Required)
- diagnosis: 1 year (Preferred)
- Utilization management: 1 year (Required)
- GAMMIS: 1 year (Preferred)
- clinical documentaion review: 1 year (Preferred)
License/Certification:
- LPC, LCSW, LMFT, or Psychologist license? (Required)
Work Location: In person