Utilization Review Specialist

Salary: $40170.00Location: Akron(Portage Lakes area)Schedule: Mon/Tue/Wed/Thur/Fri 8:30 AM - 5:00 PMBachelors degree requiredOUR MISSION AND PERFORMANCE EXPECTATIONS The MENTOR Network is a mission-based organization dedicated to providing high quality services to those we serve. Therefore to deliver on our mission The Network expects every employee to perform his or her job first and foremost in accordance with the Companys mission. SUMMARY The Utilization Review Specialist is responsible for proactive planning measures accurate documentation of services delivered for audit assurances and positive outcomes regarding effective service utilization to customers. Provides professional oversight of service delivery authorizations and assurances effective tracking and timely recommendations in regards to service delivery utilization parameters and quality assurance of service delivery records on an ongoing basis. ESSENTIAL JOB FUNCTIONS To perform this job successfully an individual must be able to satisfactorily perform each essential function listed below: Develops plans to accurately measure documentation of services delivered to assure compliance with auditorsOversees service delivery authorizations and provides quality assurances of service delivery records Reviews all service delivery documentation Analyzes the delivery of services and coordination of required service documentation including corresponding billing tickets Tracks current and approved Individual Service Plan and corresponds with areas of support services and service delivery documentation records Verifies billing ticket/pre invoices submitted for processing with all required information Recommends service delivery utilization parameters Maintains knowledge of updated funding Rules and Contracts Notifies internal stakeholders for any updated information on service delivery authorizations and utilization of services Maintains organized and complete records and assures quality focused service delivery method strategies Monitors the regional office and storage filing systems Organizes records including availability for compliance audit file review Provides technical assistance to clinical staff in the service areas Facilitates timely and appropriate service authorization Monitors strategies Provides report analysis of actual service deliveries in comparison to authorized service approvals May direct and supervise clerical and administrative staff Provides feedback on performance evaluations Conducts scheduling orientation and training Resolves issues and serves as resource Performs other related duties and activities as requiredSUPERVISORY RESPONSIBILITIESMay direct and supervise clerical and administrative staff including performance evaluations scheduling orientation and training. Provides feedback on employee performance and resolves issues within position Knowledge and Skills required by the Job The requirements listed below are representative of the knowledge skill and/or abilities required to perform the job: Education and Experience: Bachelors degree required 1 year minimum work experience in human services requiredCertificates Licenses and Registrations: NoneOther Skills and Abilities: For Ohio Basic Excel skills and ability to learn the Ohio state billing softwareOther Requirements: Travel as neededPhysical Requirements: Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift carry push pull or otherwise move objects including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. AMERICANS WITH DISABILITIES STATEMENT External and internal applicants as well as position incumbents who become disabled must be able to perform the essential job functions either unaided or with assistance of a reasonable accommodations to be determined on a case by case basis.