Utilization Management Director jobs in Georgia

UTILIZATION MANAGER

Position Description:

Under the direction of the Clinical Director, this position performs professional work involving the oversight of the delivery of mental health and addictive disease services. This position oversees and administers a wide range of services in a high-intensity clinical environment. These services include but are not limited to the following: a review of behavioral health and/or diagnostic assessments, training, and treatment plans. This position requires critical thinking skills, the ability to problem solve quickly and efficiently, and broad knowledge of the DSMV, therapeutic processes, and methodologies.

1) Submits the IRP, Behavior Rating Scale, and Authorization form to ASO or the appropriate CMO and add authorization for client services.

2) Corrects Individualized Resiliency Plans / Treatment Plans as specified by ASO or CMO's.

3) Send behavioral symptoms rating scale, reauthorizations and OTR form back to contractors for corrections as needed.

4) Utilization Manager needs to ensure that all initial and reauthorization treatment plans are SMART and Measurable prior to submitting them for final approval in the system.

5) Monitor MICP System and CMO system daily for approval of all initial treatment plans and reauthorization.

6) Clients in Brief/Ongoing put in ASO reauthorization along with the Treatment plan from Sharenote

7) Provides formal teaching, consultation, and in-service training to staff members covering a variety of clinical and administrative topics.

8) Communicate with the immediate supervisor any concerns/needs of the Department and brainstorm solutions.

9) Input the initial treatment plan and ongoing goals into Sharenote.

10) Other duties as assigned.

• Minimum Qualifications:

• Must have a Master’s degree in social work, clinical psychology, counseling, or a closely related field and actively working toward licensure.
• Experience completing assessments and Individual Resiliency Plans preferred.
• Demonstrated knowledge of mental health disorders and treatment methods.
• Ability to provide skilled treatment to clients with social and behavioral problems.
• Ability to establish and maintain working relationships with consumers, families, service providers, and colleagues.
• Ability to provide skilled treatment to clients with social and behavioral problems.
• Ability to establish and maintain working relationships with consumers, families, service providers, and colleagues.
• Knowledge of clinical operations and procedures, Medicaid services, and community mental health resources.
• Advanced knowledge of clinical social work and mental health counseling principles, methods, procedures, and standards.
• Knowledge of clinical operations and procedures, Medicaid services, and community mental health resources.
• Experience in quality improvement processes, auditing, and clinical records documentation.
• Strong written and verbal communication skills.
• Exceptional verbal and written communication skills.

Job Types: Part-time, Contract

Pay: $15.00 - $20.00 per hour

Expected hours: 10 – 20 per week

Benefits:

• Flexible schedule
• Free parking

Healthcare setting:

• Outpatient

Medical specialties:

• Psychiatry

Schedule:

• Monday to Friday

Education:

• Master's (Required)

Experience:

• Documentation review: 2 years (Required)
• Mental health counseling: 2 years (Required)

License/Certification:

• OTR request/ submission experience (Required)

Work Location: Hybrid remote in Riverdale, GA 30274