Utilization Manager - Remote (Georgia)

Requisition #: req6777

Location: Virtual (Georgia)

Hours: Full-Time (40 Hours/Week)

Bethany is changing the world through family. We began our work by serving one more than 75 years ago. Today, Bethany is an international Christian nonprofit partnering with communities in more than 30 states and in several countries around the world. We strengthen and preserve families, support displaced people fleeing danger, and find safe, loving families for ren who need them. Bethany is at the forefront of creating and implementing solutions to meet the growing needs of vulnerable ren and families in the U.S. and around the world.

As a Program Utilization Specialist, you will provide administrative and therapeutic support to the Clinical Services Department as defined by DBHDD guidelines and Bethany policy. This position is responsible for utilization review and management of clients referred for services, intake, and assessment as well as clinical counseling.

ESSENTIAL JOB RESPONSIBILITIES:

• Report weekly/monthly statistics of case closures/openings/clients served for clinical

• Responsible for obtaining all service authorizations and re-authorizations prior to beginning

• Weekly review of Medicaid/insurance verifications and assist with appropriate authorizations

• Ensure weekly completion and submission of productivity reports by clinicians;
• Manages the certification for billing process - tracks, reviews and approves all clinician documents and reports;
• Monthly tracks and analyzes service utilization patterns;
• Advises and mentors clinicians with regards to operational procedures involving work

• Fulfill the reporting guidelines as set up by Bethany Christian Services and Georgia Department of Mental Health, Developmental Disabilities and Addictive Disease;
• Actively participates with Bethany’s finance department to ensure appropriate billing;
• Establish and maintain community resources;
• Review case client case records and assure compliance with Medicaid/Insurance documentation standards;
• Track and monitor staff case record entries and ensure that all weekly billing is entered in the

• Attend all scheduled agency and program required trainings as outlined in Policy and Procedures manual;
• Provide therapy to clients where assigned. Maintain a weekly caseload of 4- 6 clients;
• Participate in weekly meetings and all other agency required meetings;
• Participate in performance improvement team;
• Complete intake and psychosocial assessments on clients as needed;
• Perform other duties as assigned

Qualifications:

• MSW or M.A./ M.S. in Social Work, Sociology, Psychology, or Counseling from an accredited college;
• A minimum of four (4) years of field experience working with ren and youth in mental health setting;
• Professional Licensure preferred;
• Demonstrate strong verbal and written communication skills;
• Excellent knowledge of mental health field and population served;
• Knowledge of development and mental health diagnoses;
• Understands the management of UM data, insurance processes and billing;
• Exercise a high level of confidentiality;
• Must have an ability to provide excellent and compassionate customer service;
• Must be reliable with time sensitive deadlines and tasks;
• Work well under pressure and adaptable to change;
• Must be a team player with a collaborative attitude;
• Computer and typing skills sufficient to perform essential job functions;
• Active motor vehicle license and a reliable vehicle with adequate insurance coverage;
• Pass a criminal history screen, including state and local protection agency registries.
• Subscription to and integration of the agency Statement of Faith, Mission Statement, and Cultural Diversity Commitment.

We value and embrace the principles of diversity, equity, and inclusion; our culture is strengthened and our workplace is more dynamic. We are a global organization with multicultural staff, clients and stakeholders, so we strive to create a workplace that reflects the communities we serve and where everyone feels empowered to bring their full, authentic selves to work. More work remains, but we are deeply committed to honestly acknowledging and addressing the impacts of race and racism throughout the organization. This work can be uncomfortable and even painful, but we believe that the greatest challenges bear the greatest rewards.

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