Utilization Review Assistant

About the role

The Utilization Review Assistant position supports the Utilization Review team under the direction of the Coordinator of Utilization Review. This role involves supporting the filing, tracking, scheduling, and communication processes related to the Utilization Review team. Key responsibilities include managing discharges, participating in collaborative calls with Managed Care Organizations (MCOs), uploading necessary documents, and preparing meeting minutes.

Responsibilities

• Manage discharges across all 820 programs; confirm discharge documentation was received and processed accordingly by managed care organizations.
• Participate in collaborative calls with MCOs to confirm client’s engagement in treatment.
• Upload admissions LOCADTR, concurrent review LOCADTRs, and pertinent UR documentation such as legal mandates, MCO correspondence, and discharge documentation to be filed in the department SharePoint and the electronic health record.
• Receive, track, and distribute information from MCO case management staff for clients receiving enhanced benefits plans such as HARP.
• Track and maintain MCO correspondence on SharePoint for intradepartmental use.
• Retrieve voicemails and faxes for the department and transcribe the information into the team calendar and team SharePoint.
• Schedule live reviews & peer-to-peer sessions for the Coordinator of Utilization Review and relevant parties.
• Prepare, file, and submit monthly updates on the progress of identified projects, rosters, retention, and reports as needed.
• Attend regularly scheduled staff meetings and case conferences.
• Communicate in a positive, professional manner at all times.

Requirements

• A high school diploma or GED, with 3 years’ experience in an administrative support role in a healthcare setting, or an associate degree in healthcare/Business Administration or a related field.
• Highly organized and able to manage multiple projects and priorities to meet deadlines and revenue goals.
• Effective communicator, both orally and in writing.
• Ability to work within a multi-disciplinary team, build relationships, and foster partnerships.
• Proficiency with computer operations (Microsoft Word, Excel, Electronic Health Records, and Outlook programs).

Qualifications

This position requires a 35-hour work week, a vacation plan and holiday schedule, life insurance, medical insurance (two plans), dental and vision insurance, additional insurance coverages (hospitalization, accidental, critical illness coverage), long-term and short-term disability, flexible spending account/health reimbursement account, 403(b) plan, corporate counseling associates (CCA) EAP benefit, ability assist counseling services (through The Hartford), commuter benefits, educational assistance programs, special shopping discounts through ADP Marketplace and PlumBenefits, RUFit?! Fitness Program, pet insurance, legal assistance, optum financial service through ConnectYourCare, benefit advocacy center through Gallagher, and Odyssey House offers a comprehensive benefits package.

Skills

Proficiency with Microsoft Office applications, electronic health records, and communication skills are essential for this role.

Benefits

Odyssey House offers a comprehensive benefits package including:

• Vacation Plan and Holiday Schedule
• Life Insurance
• Medical Insurance (Two Plans)
• Dental and Vision Insurance
• Additional Insurance Coverages (Hospitalization, Accidental, Critical Illness Coverage)
• Long-Term & Short-Term Disability
• Flexible Spending Account/Health Reimbursement Account
• 403(b) Plan
• Corporate Counseling Associates (CCA) EAP benefit
• Ability Assist Counseling Services (through The Hartford)
• Commuter Benefits
• Educational Assistance Programs
• Special Shopping Discounts through ADP Marketplace and PlumBenefits
• RUFit?! Fitness Program
• Pet Insurance
• Legal Assistance
• Optum Financial Service through ConnectYourCare
• Benefit Advocacy Center through Gallagher

Pay

The salary range for this position is $20.00 - $25.00 per hour.

Schedule

The Utilization Review Assistant works a 35-hour work week.