Utilization Review Coordinator

Program Administration Utilization Review Coordinator $23.08-24.04 hourly Monday-Friday - Remote Based in Eastern timezone  Do you have experience in Title XIX program rules, regulations, and limitations, and want to join a company that positively impacts the lives of the many individuals it serves? In the Program Administration Utilization Review Coordinator role, you will contribute to the company’s commitment to serve others by ensuring adherence to Title XIX waiver regulations/limitations and managed care authorizations. Assist in the collection of service provisions and current service information for upcoming team meetings or service change review meetings  Conduct service authorization reviews and receive confirmation from program supervisor(s) for approval of all pending and final service authorizations  Provide analysis to assure that service delivery corresponds with service support hours and units, staff hours and assignments, payroll hours and billing tickets, etc.  Effectively track/assure that current and approved Individual Service Plan(s) appropriately correspond and match areas of support services and service delivery documentation records  Maintain incoming service delivery documentation and corresponding billing tickets/pre-invoice received for processing in the regional office  Establish and monitor the regional office/storage filing systems to assure information is organized, complete, and retrievable  Actively engage in on-going communication with AR coordinators and/or AR accountants to facilitate timely resolution to outstanding issues and items pending payment for services provided to customers  Assist 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  Assure and maintain functional knowledge base and materials related to current and new funding rules and contracts  Assist Utilization Specialist in recruiting, screening, and evaluation of personnel  Make recommendations for hire; conduct initial/on-going in-service, certification, and training; oversee/evaluate work  Qualifications: High School diploma or equivalent  Minimum 1 year of experience working with Title XIX waiver program rules, regulations, and limitations  Ability to manage/prioritize multiple tasks  Effective communication skills and well-developed problem-solving skills  Exceptional attention to detail and a commitment to quality in everything you do  Foster culture of continuous improvement  Why Join Us? Full compensation/benefits package for full-time employees. 401(k) with company match  Paid time off and holiday pay Complex work adding value to the organization’s mission alongside a great team of coworkers  Enjoy job security with nationwide career development and advancement opportunities  We have meaningful work for you – come join our team – apply today!