• Minimum of 2 years of case management and/or utilization review experience
• Strong problem-solving and advanced analytical skills necessary to read, understand, interpret and analyze statistical data
• Excellent oral, written, organizational and interpersonal communication skills
• Ability to communicate effectively with senior leadership as well as other clinical/non clinical directors, managers, staff, consultants and MCOs
• Demonstrated ability to effectively collaborate with peers and senior leadership on project assignments and group presentations
• In depth knowledge on HIPAA, OASAS, and 42 CFR regulations
• Working knowledge of quality assurance and utilization review systems
• Computer literacy including proficiency in Microsoft Office Suite and HER
• Experience working directly with people from diverse racial, ethnic, and socioeconomic backgrounds
• Competency in written, interpersonal, verbal, and computational skills to present and document records in accordance with program standards
• Ability to work independently
Reasoning Ability:
• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Mathematic Skills:
• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages.
Language Skills:
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of employees of the organization. Possess the ability to deal tactfully with personnel, clients, family members, government agencies/personnel and the general public, under all conditions/circumstances.