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Utilization Program Specialist
Utilization Program SpecialistCity of Chesapeake • Chesapeake, VA, US
Utilization Program Specialist

Utilization Program Specialist

City of Chesapeake • Chesapeake, VA, US
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  • [job_card.full_time]
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Job Description

The purpose of this position is to implement and administer the Children Services Act (CSA) utilization management component of the program and to ensure the provision of quality services for children/families. This position is responsible for utilization management, compliance with policy and procedures, and reporting. This position works within a general outline of work to be performed; develops work methods and sequences under general supervision.

TYPICAL TASKS
  • Performs provider site visits to ensure compliance with contract guidelines, evaluates service provision and make recommendations related to ongoing contracting for services.
  • Performs utilization review of cases receiving the most intensive/restrictive services as assigned.
  • Communicates concerns with compliance and provides recommendations to vendors in accordance with state and local laws as well as CSA policy and procedures.
  • Acts as a support to the FAPT Coordinator by serving as a back-up as assigned and when and takes FAPT minutes weekly to ensure familiarity with cases.
  • Gathers and maintains information to support periodic and special reports; documents activities and events for area of responsibility and provides report to CSA Coordinator.
  • Performs administrative tasks such as researching files/records, charting, typing reports, telephoning, faxing, and photocopying.
  • Attends staff, team, and other professional meetings to exchange information.
  • Identifies training needs and works with FAPT Coordinator to facilitate training for FAPT members and stakeholders.  Performs other related duties as assigned.

The City of Chesapeake offers an exceptional range of benefits. Please browse our for a full list of benefits and employee perks. Required Qualifications VOCATIONAL/EDUCATIONAL REQUIREMENTS: Requires a bachelor’s degree or any equivalent combination of education and experience in social/behavioral science or closely related field.

EXPERIENCE REQUIREMENTS: In addition to satisfying the vocational/education standards, this class requires a minimum of one year full-time related experience with social services. Auditing experience preferred.

SPECIAL CERTIFICATIONS AND LICENSES: Requires a valid driver’s license and driving record in compliance with.

SPECIAL REQUIREMENTS: Employees may be expected to work hours in excess of their normally scheduled hours in response to short-term department needs and/or City-wide emergencies. Preferred Qualifications
  • Strong auditing and monitoring 3-5 years experience
  • Ability to analyze data, contracts, and service agreements
  • Knowledge of compliance, utilization review, and program oversight
  • Excellent written and verbal communication skills
  • Ability to work independently while collaborating with internal and external stakeholders
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Utilization Program Specialist • Chesapeake, VA, US

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