Utilization Management Assistant at Highland Rivers Health in Rome, Georgia

Job Description:

There is a place for you at Highland Rivers Behavioral Health!Highland Rivers provides treatment and recovery services to individuals impacted by mental illness; substance use disorders and intellectual developmental disabilities.Are you ready to make a Difference?JOB SUMMARY:The Utilization Management Department works closely with the Billing Department, and other internal programs/external entities to obtain authorization of services rendered by the agency to ensure timely reimbursement. The Utilization Management Assistant ensures the agency provides quality services and complies with agency, state, and federal guidelines.Duties and Responsibilities include:

• Offers Admin Support to Utilization Management staff.


• Run, review, and distribute various UM reports to appropriate staff weekly.


• Review Connects Registration requests for accuracy and place in UM Complete or the appropriate status. Notify the appropriate staff member when corrections are needed.


• Review Connects Non-CSU Discharge requests for accuracy and place in UM Complete or the appropriate status. Notify the appropriate staff member when corrections are needed.


• Follow-up to assure that Connects Registrations and Non-CSU Discharge rejections are resolved in a timely manner.


• Review Wellspring census, check payers, and notify staff of any needs.


• Health and Safety Officer and related duties.


• Other duties as assigned.


• Coordinate CSU/CMO related authorization needs.

• Health Insurance through the State Health Benefit Plan of GA


• Flexible Benefits such as dental, vision, life, critical illness, etc.


• Retirement Plan with employer matching


• 4 weeks of Paid Time Off with increase of accruals based on years of service


• 10 paid holidays


• 1 personal day


• Qualifying employer for Public Student Loan Forgiveness


• NHSC loan forgiveness in qualifying counties.


• Clinical supervision for candidates on a licensure track.