Utilization Review Analyst

Job Details

Job Location

Bronx, NY

Position Type

Full Time

Education Level

4 Year Degree

Salary Range

$45,000.00 - $50,000.00 Salary/year

Travel Percentage

Up to 25%

Job Shift

Day

Job Category

Nonprofit - Social Services

Description

Comunilife Inc.is looking for aUtilization Review Analystfor its newRehabilitation and Tenancy Support Services Program (RTS)Thisposition reports to theRTS Program Managerand will support the 6 program directors and their staff that have OMH supportive housing. This program was established as of January 1, 2023, and allows agencies that provide housing services to clients in units funded by NYS Office of Mental Health (OMH) to bill Medicaid for certain services. The program is designed to assist individuals who are transitioning from institutional care or temporary settings into permanent housing. The individual receives RTS services which help them to develop independent living skills and achieve housing stability. The services focus on reducing disabling symptoms related to mental illness and substance use and increasing individuals’ ability to maintain a household and integrate into the community.This position is eligible for Comunilife’s generous benefits and paid time off package and is salaried up to $50,000 a year.

Essential functions:

• Analysis of CAIRS and AWARDS data

• Development of reports, data reviews, charts/graphs and other tools to display data and data findings.

• Responsible for integrity of data; identification of data discrepancies and support to RTS program staff to resolve any issues that arise

• Responsible for ensuring compliance with policies and procedures in compliance with Federal, State and City Laws, rules and regulations

• Ensure that Quality Improvement Policies and Procedures are follow as required

• Ensure program compliance with OMH contract requirements

• Regularly review and monitor assessors output activities to ensure that benchmark are met.

• Monitor data in CAIRS and AWARDS to ensure that data integrity in compliance with Medicaid billing requirements.

• Provide oversight in maintaining and securing individual files and records to ensure that files are kept complete, current, and readily identifiable from other Comunilife programs. Ensure that all client records are maintained by Comunilife for a minimum of seven (7) years after the expiration of the contract.

• Maintain all documents necessary for a quality assurance and improvement review by Comunilife or OMH.

Qualifications

Qualifications

Education and Experience Requirement(s)

Bachelor’s Degree in the liberal arts, including but not limited to Psychology, social work, public health, health administration, or related field; and two (2) years or more of experience in program development data analysis, research, auditing or program administration. Proficient in the use of technology including excel, project management tools, flow charting software, powerpoint and other analytical software tools is essential.

Comunilife is an EEO employer and provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.