Utilization Case Manager
2 weeks ago
Helio Health is a leading provider of behavioral healthcare services, and we are seeking a highly skilled Utilization Case Manager to join our team.
Job Summary:The Utilization Case Manager will play a critical role in enhancing our program's efforts to track, review, and analyze data related to continuous quality improvement. This position will support our Inpatient, Detox, and Residential programs on a Full-Time basis.
Responsibilities:- Review precertification requests for medical necessity and refer to medical providers those that require additional expertise.
- Review clinical information for concurrent reviews and extend the length of stay for patients/residents as appropriate.
- Assist in developing and administering policies and procedures for utilization.
- Negotiate access to care for individuals seeking services at Helio Health, Inc.
- Educate program staff on current principles and standards of practice surrounding utilization and denials management.
- Use effective relationship management, coordination of services, resource management, education, and patient advocacy to promote improved quality of care and/or life.
- Perform quality assurance activities, including providing services according to agency policies, procedures, program guidelines, and governmental regulations.
- Associate's degree required, Bachelor's degree preferred.
- Licensed/credentialed applicants preferred.
- Two years of experience in utilization review in a hospital, healthcare, or managed care setting.
- Knowledge of federal and state regulations applicable to treatment and reimbursement.
- Utilization review procedures and techniques.
- Health insurance including dental and vision for employees and families.
- Paid Vacation and Sick leave - No Waiting Period for accruals.
- Paid holidays, including a floating birthday holiday.
- 401(k) plan with up to 5% company match.
- Company paid short-term disability insurance.
- Company sponsored life insurance.
- Employee Assistance Program (EAP).
Helio Health provides equal opportunity to all employees and applicants for employment, without regard to race, creed, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, religion, national origin, citizenship, status as a victim of domestic violence, age, military or veteran status, handicap or disability, family medical history or predisposing genetic characteristics or carrier status, marital status, family status, political affiliation, felony conviction record, status as a victim of a crime, or status as an employee who has complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit, or any other categories, status, or activity protected by federal, state, or local law.
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Utilization Case Manager
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Syracuse, New York, United States Helio Health Full timeJob Title: Utilization Case ManagerHelio Health is seeking a highly skilled Utilization Case Manager to join our team. As a Utilization Case Manager, you will play a critical role in enhancing our program's efforts to track, review, and analyze data relating to continuous quality improvement.Job Summary:The Utilization Case Manager will work on a Full-Time...
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Utilization Case Manager
2 days ago
Syracuse, New York, United States Helio Health Full timeJob Title: Utilization Case ManagerHelio Health is seeking a highly skilled Utilization Case Manager to join our team. As a key member of our healthcare team, you will play a critical role in enhancing our program's efforts to track, review, and analyze data relating to continuous quality improvement.Responsibilities:Review precertification requests for...
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