Utilization Review CoordinatorApply Now Job ID 17000OGF
Utilization Review Coordinator
Primary Location: CA-CARancho Cucamonga-9166 Anaheim Place
- Assists in collection of service provision (planned, actual, over utilized) and current service information for program supervisor(s) for upcoming team meetings or service change review meetings.
- Conducts Service Authorization reviews and receives confirmation from program supervisor(s) for approval of all pending and final service authorizations.
- Provides analysis to assure that service delivery (planned to actual) correspond in areas of service support hours and units, staff hours and assignments, payroll hours and billing tickets, etc.
- Responsible for daily coordination and tracking systems of incoming service delivery documentation and corresponding billing tickets/pre invoice received for processing in the regional office. Performs weekly, bi-weekly, and monthly reviews and verifies completeness of required information. Reports status of various service delivery targets and projects outcomes to supervisor.
- Assists in communication with Interdisciplinary Planning Teams to address areas of identified errors, corrections, or needed services related to billing units and over/under utilization areas.
- Assures and maintains functional knowledge base and materials related to current and new funding Rules and Contracts, provides updates and information to supervisor and/others specific to impact on service delivery, authorizations, and utilization of services.
What we require of you:
·High School Diploma or equivalent and one year experience.
·Experience with Medi-cal and/or Department of Mental Health billing and funding
- Demonstrated knowledge of Microsoft Office products
- Experience with Hyperion and Oracle preferred
- Demonstrated leadership ability
- Ability to effectively establish and maintain meaningful relationships
- Ability to coordinate activities and services to meet the on-going needs of individuals served
- Strong follow through to ensure quality services, regulations and clients’ rights are upheld
- High energy, goal-oriented, and an ability to inspire people
- Access to a registered vehicle with proof of insurance
- Must be at least 18 years of age
- Must pass background investigation that includes FBI/DOJ fingerprint check
- A competitive compensation/benefits package including 401(k) with company matching
- Annual bonus plan
- A rewarding work environment
- Meaningful relationships with your co-workers and the individuals we serve
- Time Off & Holiday Pay
- Family-oriented environment, casual dress
- Employee discounts; fun employee events
- Dynamic work environment, no day is ever the same as the next
- On-the-job training including paid CEU opportunities, career development and advancement opportunities
- Access to jobs throughout the nation-wide Network
- Mileage reimbursement
Bring the right attitude; we’ll train you for success!
We have a great work environment and you’ll be surrounded by a strong and supportive team of peers, leaders and colleagues. California MENTOR is a part of The MENTOR Network. The MENTOR Network is a national network of local human service providers offering quality, community-based services. With approximately 28,000 employees serving 25,000+ consumers in 36 states, you'll have career opportunities from coast to coast. When you join The MENTOR Network, you’ll make a difference every day and help to provide quality of life enhancing services to individuals across the country.