Utilization Review Specialist

Your responsibilities in this role may include:

1. Treat all clients and staff with dignity and respect.

2. Develop and maintain efficient assessment procedures which quickly link individuals to the appropriate level of treatment.

3. Ensure individuals are referred to appropriate levels of care within Gaudenzia, Inc.’s treatment continuum, where appropriate.

4. Ensure accurate, up-to-date intake records, records of referral, and funding source documents are compiled and stored within the electronic health record system within the required timeframes.

5. Develop and maintain efficient assessment procedures and processes and oversee the flow of clients and their related documentation between the assessment/ evaluation unit(s) and treatment programs.

6. Participate in multidisciplinary case management meetings and telephonic referrals for individuals presenting for admission.

7. Demonstrate proficiency with the administration and interpretation of assessment tools and knowledge of the criteria for Gaudenzia’s programs.

8. Establish and maintain positive relationships with funding, referral, and regulatory agencies.

9. Other duties as assigned by supervisor or designee.

Qualifications

Qualifications for This Role:

 

Education/ Training:  Must hold a degree from an accredited college or university.

 

Experience:              

• Associate’s Degree with at least 4 years of experience
• Bachelor’s Degree with at least 3 years of experience
• Master’s Degree with at least 2 years of experience

 

• Knowledge of the principles, practices, and procedures involved in treatment programs and continuum of care. Knowledge of correct record keeping in accordance with regulatory agencies and standards of practice.
• Knowledge of regulatory, licensing, and accreditation standards.
• Knowledge of and ability to work with electronic health record systems.
• Ability to exercise sound judgment in developing, implementing, interpreting and evaluating program policies, procedures and regulations.
• Ability to communicate effectively, both verbally and in writing.
• Ability to work with clients to gain confidence and cooperation.
• Ability to successfully work with others from various cultures and backgrounds.
• Ability to plan and organize work and prepare appropriate, accurate records, and reports.
• Ability to establish and maintain effective working relationships with clients, staff, health care providers, referral entities, outside agencies, institutions and the general public.
• Skilled at using computers, including familiarity and faculty with Microsoft Office programs like Word and Excel.