Utilization Review Specialist
$65k/y-$75k/y
Odyssey Housea day ago
Highlight
OnsiteFull-timeMid
Summary
Odyssey House is seeking a Utilization Review Specialist to join their Clinical department at the George Rosenfield Center for Recovery in New York, NY. The role involves coordinating Medicaid Managed Care authorizations and ensuring uninterrupted service provision for clients receiving behavioral healthcare services.
About the Role
As a Utilization Review Specialist, you will be responsible for managing Medicaid Managed Care authorizations, monitoring claims, and ensuring compliance with documentation requirements. You will conduct utilization, discharge, and peer reviews, initiate appeals, and collaborate with a multi-disciplinary team to improve service delivery. Staying updated on quality assurance developments in substance use and mental health treatment is essential.
About You
Required:
- Master’s degree in social work, Counseling, Psychology, Public Health, or related field with one year of experience in a relevant role, or at least 5 years of progressive responsibility in a social service or healthcare role.
- Qualified Health Professional (LCSW, LMSW, LMHC, LMFT preferred) CASAC-T required with the ability to secure CASAC within 6 months from hire.
- Strong understanding of managed care systems, including LOCATDR 3 criteria and behavioral health benefits.
Preferred:
- Knowledge of OASAS regulations.
- Highly organized with the ability to manage multiple projects and priorities.
- Effective communication skills, both orally and in writing.
- Proficiency in Microsoft Word, Excel, Electronic Health Records, and Outlook.
Benefits
- A 35-hour work week.
- Vacation Plan and Holiday Schedule.
- Life Insurance.
- Medical Insurance (Two Plans).
- Dental and Vision Insurance.
- Additional Insurance Coverages (hospitalization, accidental, critical illness).
- Long-Term & Short-Term Disability.
- Flexible Spending Account/Health Reimbursement Account.
- 403(b) Plan.
- Corporate Counseling Associates (CCA) EAP benefit.
- Ability Assist Counseling Services.
- Commuter Benefits.
- Educational Assistance Programs.
- Special shopping discounts.
- RUFit?! Fitness Program.
- Pet Insurance.
- Legal Assistance.
- Optum Financial Service.
- Benefit Advocacy Center.
Odyssey House
Odyssey House helps New Yorkers in need overcome drug and alcohol abuse, improve their physical and mental health, and defeat homelessness. We call it “getting real” about recovery. And that’s more than a slogan. It’s Odyssey House’s way of supporting total well-being, so you can live a healthy, happy and substance-free life. ___________________________________________________________________________________________________________________ CAREERS: We offer a range of full-time, part-time and weekend opportunities, including: • Program directors • Social workers • Counselors • Resident assistants • Child care workers • Administrators • Financial/Accounting • Clerical operations
New York, NY