JOB DESCRIPTION: UTILIZATION MANAGER

job description : UTILIZATION MANAGER . Job Summary o To oversee the implementation of Mosaic's UTILIZATION Management and UTILIZATION Review Plans. Responsibilities General: Adheres to all current federal & state laws, as well as Mosaic's Policies and Procedures, including the safeguarding of confidential healthcare information and compliance with the Health Insurance Portability &. Accountability Act (HIPAA). Reports immediately any suspected incidents of child abuse or neglect to the Child Abuse Hotline Establishes relationships and communicates with clients, caseworkers/probation officers, family members, and staff Identifies and seeks resolution for potential problems arising with staff or other involved parties Attends staff / agency meetings Completes other duties as directed by the Clinical Treatment Director Administration: Primary function is UTILIZATION management, conducting UTILIZATION review and granting and denying authorizations for all Levels of Care (LOCs) and services as part of the Texas Department of State Health Services UTILIZATION Management (UM) Guidelines Conducts perspective, concurrent, and retrospective reviews for authorization of LOCs/services

JOB DESCRIPTION: UTILIZATION MANAGER Job Summary o To oversee the implementation of Mosaic’s Utilization Management and Utilization Review Plans.

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