Utilization Manager
Now Hiring: Utilization Manager Location: Woodridge Interventions, 2221 64th Street, Woodridge, IL 60517 Salary: $60,000 per year Job Type: Full-time As a Utilization Manager (UM) , your primary function is to monitor and track concurrent reviews for timeliness and appropriate content. to request additional authorization. In addition, the Utilization Manager will assist in writing precertification requests for new admissions, monitoring and resolving eligibility issues and other health insurance issues. Who We Are: Abraxas Youth & Family Services is a national nonprofit human services provider dedicated to Building Better Futures for at-risk youth, adults, and families. Our diversified array of services includes alternative education, outpatient counseling, in-home services, shelter, detention, residential treatment and re-entry/transition services. Since 1973, Abraxas team members have positively impacted the lives of those we serve and the communities in which they live. Benefits & Perks: We provide a competitive and comprehensive benefits program that offers the protection, peace of mind and flexibility designed to support you – both at home and at work. Medical & Dental & Vision Insurance Flexible Spending Accounts Basic Life & Short-Term Disability Insurance 401(k) Life Assistance Program (LAP) Tuition Assistance Program Paid Time Off (PTO) * Paid Holidays * Paid Training Advancement Opportunities Utilization Manager (UM) Essential Duties & Responsibilities: • Reviews authorizations for placement and referral which includes providing referral authorizations, concurrent reviews, proactive discharge and transition planning and appropriate referral to case management. • Monitors all utilization reports to assure compliance with reporting and turnaround times. • Performs continued stay and retrospective reviews for movement to another level of care. • Prepares and submits clinical appeals for inappropriate referrals. • Impacts length of stay and influences use of resources by sharing knowledge with clinical and medical staff as well as community resources. • Monitors patient’s clinical progress and coordinates patient care from admission to discharge. • Assists clinical staff with chart audits and filing to assure compliance with contract requirements. • Encourages optimum utilization of medical care, appropriate level of care and utilization of hospital beds • Keeps current with regulation changes and informs staff of al updates and changes • Maintains current knowledge of community agencies and services, medical necessity and clinical criteria for Residential Treatment Center (RTC) level of care. • Demonstrates knowledge of and maintains records associated with Prison Rape Elimination Act (PREA). • Attends staff meetings and participates in department activities and programs • Implements Company policies. • Maintains knowledge of each client’s problem areas. Minimum Requirements: The following educational requirements are acceptable for this classification including: Bachelor’s degree in behavioral health field and two years of behavioral health case management experience; four years experience in related field preferred. Experience working with Medicaid and state-specific behavioral healthcare systems, and demonstrated skills in working, communicating, and collaborating with state agencies; hospital utilization review experience or managed care background preferred. Required: Must have knowledge of the new 2060 regulations and DSM IV, plus experience providing authorizations and re-authorizations for patients with SUD/MH patients Other Qualifications: At least twenty-one (21) years of age. Criminal clearances and background check. Valid driver's license from employee’s state of residence •Ability to work with computers and the necessary software typically used by the department. Why Should You Consider Abraxas? At Abraxas , we celebrate the richness of our diverse employees and the communities we serve. We are actively committed to building a culture of awareness and belonging, as we strive to ensure we are a welcoming, inclusive, and culturally competent organization. As we work to make a difference in people’s lives, we are dedicated to respect, equity, and the engagement of those we serve and our employees. As a provider of trauma-informed care, we firmly believe in recovery and that our clients can lead fulfilling and meaningful lives, and we consider it an honor and a privilege to assist them in their journey. Whether you’re looking to begin a rewarding career or you’re a seasoned professional wanting a new challenge, we have a place for you and opportunities for development at all levels. At Abraxas , everything we do centers around people. That is why we are committed to providing you with competitive pay and comprehensive benefit options that help make your life easier and healthier, with a focus on providing choice when it comes to physical, emotional and financial wellness. Our benefit options meet you where you are in your life and set you up for success both in and outside of work. If you want to have a positive impact in the lives of others, come join us! About Company Apis Services, Inc. (a wholly owned subsidiary of Inperium, Inc.) provides a progressive platform for delivering Shared Services to Inperium and its Constellation of affiliate companies. Allowing these entities to advance their mission and vision. By exploring geographical program expansion and focusing on quality outcome measures to create cost savings that result in reinvestment into the organizations, stakeholders through capacity creation and employee compensation betterment. Inperium Inc., Apis Services, Inc. and affiliates provide equal employment opportunities for all employees and applicants for employment in compliance with all federal and all applicable state and local laws and regulations, including nondiscrimination in hiring and employment. All employment decisions are made without regard to race, color, religion, gender, national origin, ancestry, age, sexual orientation, gender identity and expression, disability, genetic information, marital status, pregnancy/childbirth, veteran status or any other basis protected by law. This policy of non-discrimination and equal employment opportunities extends to every phase and aspect of hiring and employment. Equal Opportunity Employer Abraxas Youth & Family Services , an affiliate of Apis Services Inc., offers a rewarding career for those passionate about making a difference in the lives of others. Abraxas is a great place to start your career whether you have a high school diploma or GED, military experience, some college, or a bachelor or advanced degree. If you are interested in counseling, juvenile justice, psychology, social work, teaching or just want to make a difference, we have a career path for you. Join Us in Building Better Futures! Now Hiring: Utilization Review Manager Location: Southern Peaks Regional Treatment Center | 700 Four Mile Parkway | Canon City, CO 81212
