Manager

Job Description

Under the direction of the Director of Utilization Review, this position will provide direct supervision to all Utilization Review Coordinators and will work closely with the Clinical Assessment Counselors, Intake Coordinators, Access/Admissions team and the Business Development and Marketing Department to oversee the daily management of utilization review tasks and Access/Admission tasks for EOSIS’s commercial and legacy facilities, while providing face-to-face and/or over-the-phone managed care assistance. Duties & Responsibilities: Provide supervision to all UR staff as well as recruit, train, orient, and manage the performance of staff • Daily management of UR staff work assignments • Organize and maintain schedules for UR staff • Approve and submit UR employee timecards weekly • Engage in quarterly audits to ensure quality is assessed among UR team Develop tracking and reporting mechanisms for utilization review information across all EOSIS facilities • Compile and analyze daily, weekly, monthly, quarterly, and annual private funding statistics for comparison and projections. • Prioritize and manage all commercial admissions deploying help to optimize patient speed of access to services • Training all new hire Utilization Review Coordinators and residential counselors • Attend weekly residential treatment teams/funding meetings if needed • Monitor level of care appropriateness and necessity residential sites • Maintain utilization review timelines to ensure timely and appropriate completion. • Follow-up with counseling and medical staff as needed • Articulate relevant clinical information to managed care companies based on level of care necessity • Document all relevant financial and funding information in client electronic medical record • Work in support with business office, residential, and outpatient programs • Maintain professional working relationships with managed care companies. Maintain communication with the Director of UR on departmental standing and needs • Complete online and telephonic funding verification/eligibility • Assist with financial counseling. Qualifications Required: A current and valid Alcohol and Drug Counselor license. A minimum of two years of experience in the field of mental and chemical health required • A minimum of two years of managed care experience, completing initial, concurrent, and discharge reviews, as well as written appeals, is required • A minimum of one year of experience of Utilization Review along with one year experience in residential or outpatient behavioral health settings is highly desired • Experience working with Minnesota payers is highly preferred • Must know and understand the rules and regulations surrounding SUD treatment services. A minimum of two years freedom from chemical abuse problems • Must document 12 hours of training in co-occurring mental health problems and chemical abuse of dependency that includes competencies related to philosophy, screening, assessment, diagnosis, and treatment planning, documentation, programming, medication, collaboration, mental health consultation, discharge planning • On-going training of cultural awareness and demonstration of sensitivity to various cultural norms and values. Show more Show less