Utilization Reviewer � developmental disabilities services jobs in United States
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Liberty Healthcare Corporation · 1 day ago

Utilization Reviewer � developmental disabilities services

Liberty Healthcare Corporation is seeking a full-time Utilization Reviewer to support their partnership with Maryland’s Developmental Disabilities Administration. The role involves conducting audits of services, reviewing Medicaid claims, and analyzing service levels to enhance quality improvement processes for individuals with developmental disabilities.

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Responsibilities

Conducting audits of services provided to people with developmental disabilities
Heavy database usage
Reviewing and analyzing Medicaid claims
Analyzing actual services provided against contracted service levels and hours
Conducting in-person and phone/video interviews of individuals served as well as their caregivers
Writing summary reports

Qualification

Utilization reviewClaims reviewsHealthcare billingCase managementAnalyzing healthcare dataSolid computer skillsService coordinationPrior authorizationsMaryland DDS

Required

Bachelor's degree
Solid computer skills
Three or more years of experience in human services required, ideally in one of these areas: Supporting people who are living with developmental disabilities, Service coordination, Case management, Utilization review, Prior authorizations, Claims reviews, Healthcare billing, Analyzing healthcare or human services data

Preferred

Familiarity with the State of Maryland's Developmental Disabilities Administration
Familiarity with Home and Community Based Services

Benefits

30 days of paid time off annually
Health insurance and other perks
Reimbursement for approved work-related mileage

Company

Liberty Healthcare Corporation

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Liberty Healthcare Corporation provides population health management, health workforce outsourcing and program mangement services.

Funding

Current Stage
Late Stage

Leadership Team

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John Guda
Chief Technology Officer / Chief Information Officer
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Company data provided by crunchbase