Utilization Management Specialist

POSITION TITLE: Utilization Management Specialist

LOCATION: Louisville, KY

STATUS: Full Time, Salaried, Exempt

PROGRAM: Addiction Recovery Services

REPORTS TO: Director of Utilization Management

INTRODUCTION:
Volunteers of America Mid-States (VOA) is a non-profit organization spanning four states that creates positive change in the lives of individuals and communities through a ministry of service. We provide housing for families, veterans, and low-income seniors. We provide care and support for individuals with developmental disabilities, healing accountability that brings people together with restorative justice, and free HIV testing and education. When Volunteers of America was founded in 1896, "volunteer" referred to anyone who served others as a vocation through a commitment to a mission. Today, we are still staffed by paid, mission-driven professionals working to create positive change and build thriving communities. Flexibility, teamwork, and fun are some of the reasons our employees are proud to work at VOA! We offer a comprehensive benefits package to employees who meet eligibility requirements.

BENEFITS:
Volunteers of America Mid-States, offers a rich and robust benefits package the supports a healthy work life balance, which include the following:

Health and Wellness
Employee Assistance Plans (EAP)
Health and Wellness Program
Medical Coverage
Dental Coverage
Vision Coverage
Flexible Spending Account
Health Spending Account
Short Term Disability
MetLife Legal Plans

Financial Wellbeing
Competitive Compensation Packages
Life Insurance (company paid)
403b retirement plan with company fund matching
Employee discounts

• Loan forgiveness options through federal programs

(National Health Corp & Public Service Loan Forgiveness)

• All company paid benefits and paid time off effective day one

Work Culture
Commitment Committee
Justice Committee
Integrity Committee
Compassion Committee
DE&I Committee
Retention Committee

Training & Development
VOA LEAD Program- Leadership Development Program
VOA University - Staff Development
VOA Academy - Clinical Training and Development

JOB SUMMARY AND QUALIFICATIONS:

Under minimal supervision, assists UM department with initial and recurrent authorization protocols to ensure timely reimbursement by payers for care, treatment, and services provided by Volunteers of America. This is a work from home position and requires a private office area to protect confidentiality.

WHAT YOU SHOULD HAVE FOR THIS ROLE:
This role is very goal driven with a sales focus with skills like inspiring genuine trust, building strong relationships, and continuing to consistently following up. The position requires exceptional communication, customer service, and critical thinking skills. This position also requires skills in time management and experience with clinical services. Experience with computer programs including Microsoft Word, Excel and Outlook is required. The candidate must exhibit compassion toward people living with behavioral health and substance use issues, Hepatitis C and HIV/AIDS and the ability to convey respect to target populations and community partners. The candidate must have the background and aptitude to learn and apply Volunteers of America’s personnel and program policies and procedures.

RESPONSIBILITIES:

• Identifies and Verifies participants insurance coverage and benefits.

• Implements tracking system to obtain re-authorization for services.

• Performs various administrative functions related to obtaining authorization for services such as: documentation, data gathering, working reports, enrollments, communication with site staff, communication with Guarantors, and development of communication tools using various platforms.

• Excellent skills in the following areas: Problem solving, written and verbal communication, customer service, organization, and flexibility.

• Basic computer and data entry skills

• Knowledge of various IT platforms including but not limited to WORD, EXCEL, Outlook, CANVA

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.