Utilization Review Therapist

Summary

Odyssey House's Mission is "Empowering people to heal and build better lives." They provide substance use treatment, medical care, prevention, and mental health services. Odyssey House has received Best of State and Top Workplace Awards. This Full-Time position offers benefits such as tuition assistance, access to an Employee Assistance Program, opportunities for continuing education, and flexible scheduling.

Functions Of The Job

• Track UCE/UR/Insurance Due Dates for all funding and ensure timely submission of all requests.
• Review all UR submissions for medical necessity, make corrections to UR, and submit for approval.
• Provide ongoing training to staff regarding writing to medical necessity or other issues that present during reviewing UMs.
• Resolve funding denials through immediate UR modification and resubmission to minimize loss of days.
• Update Best Notes and UWITS, as needed, to reflect authorized days.
• Generate Reports with due dates, notify staff of changes, and manage staff progress.
• Complete monthly Medicaid check (upload snapshots to Best Notes).
• Complete “doc-to-doc” calls, as needed, for insurance authorization.
• Communicate with OH billing department to resolve issues.
• Complete all responsibilities in a timely, thorough, and professional manner.
• Demonstrate fluency in ASAM and DSM-V through successful authorization and processing of UMs.
• Other duties as assigned.

Requirements

• Licensed Mental Health Professional, including - CSW, LCSW, CMHC, ACHMC, LMFT, MFTI.
• Graduate degree in the mental health field.
• Willingness and ability to pass a criminal background check.
• First Aid and CPR Certification (available at Odyssey House).
• Must comply with annual TB tests and Flu immunization (and other immunizations as needed).
• Must meet employment eligibility.
• Must be able to work variable shifts as needed.

Physical Demands of the Job

• Ability to lift up to 15 lbs.
• Drive (or adequate alternate transportation).
• Sit for prolonged periods.
• Perform light to moderate physical activity at times.
• Able to passively restrain residents without likely injury to self due to existing medical condition.