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Chart Utilization Review Jobs in New York (NOW HIRING)

Samaritan Daytop Village

Utilization Manager

Queens, NY · On-site

$34.61 - $38.46/hr

Conducts timely scheduled/required utilization reviews for Residential Services sites. * Conducts ... Monitors and evaluates ongoing audit for chart. * Provides direct care services to clients as ...

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Chart Utilization Review information

What is chart utilization review?

Chart Utilization Review is a process commonly used in healthcare settings to assess the necessity, appropriateness, and efficiency of medical services provided to patients. It involves reviewing patient charts and medical records to ensure that treatments and procedures are justified according to established guidelines and policies. This process helps in improving patient care, managing costs, and ensuring compliance with regulatory requirements. Utilization review professionals work closely with medical staff, insurance companies, and regulatory agencies to support quality and cost-effective care.

What are some common challenges faced by professionals in chart utilization review, and how can they be addressed?

Professionals in Chart Utilization Review often encounter challenges such as navigating incomplete or inconsistent medical documentation, staying current with ever-evolving healthcare regulations, and balancing productivity with accuracy. To address these challenges, it is important to maintain open communication with clinical staff, participate in ongoing training, and utilize robust electronic health record systems. Additionally, collaborating closely with interdisciplinary teams can help clarify documentation and ensure compliance with regulatory standards.

What are the key skills and qualifications needed to thrive as a chart utilization review specialist, and why are they important?

To thrive as a Chart Utilization Review specialist, you need a background in healthcare, strong knowledge of medical terminology, and experience with patient care documentation, often supported by an RN or LPN license. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately reviewing charts and collaborating with healthcare providers. These abilities ensure compliance, optimize patient care, and support cost-effective healthcare delivery.

What is the difference between Chart Utilization Review vs Chart Review Specialist?

AspectChart Utilization ReviewChart Review Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires medical or coding certifications
Work EnvironmentHealthcare facilities, insurance companies, utilization management teamsMedical offices, insurance companies, coding firms
Employer & IndustryHospitals, insurance providers, healthcare organizationsMedical billing companies, insurance firms, healthcare providers
Primary FocusAssessing medical necessity and appropriateness of servicesReviewing medical records for coding accuracy and completeness

While both roles involve reviewing medical information, Chart Utilization Review focuses on evaluating the necessity of healthcare services, whereas Chart Review Specialists primarily verify medical documentation for coding and billing accuracy. Understanding these distinctions helps professionals choose the right career path or job search focus.

What are popular job titles related to Chart Utilization Review jobs in New York?

For Chart Utilization Review jobs in New York, the most frequently searched job titles are:

What job categories do people searching Chart Utilization Review jobs in New York look for?

The top searched job categories for Chart Utilization Review jobs in New York are:

What cities in New York are hiring for Chart Utilization Review jobs?

Cities in New York with the most Chart Utilization Review job openings:

Chart Utilization Review jobs near you
Infographic showing various Chart Utilization Review job openings in New York as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Utilization Manager

Samaritan Daytop Village

Queens, NY • On-site

$34.61 - $38.46/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Samaritan Daytop Village rating

8.0

Company rating: 8.0 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

Overview

Utilization Manager

Healthcare staff can work anywhere....The BEST work with US!

$34.61-38.46 per hour

A nationally recognized comprehensive Health and Human Services Agency, with over 60 programs across New York City and greater New York Area.

Samaritan Daytop Village, serves over 33,000 New Yorkers annually within your neighborhoods and communities so our success depends on those we employ.

The Role

In concert with the agency's mission and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as needed with assuring compliance with external and internal utilization review/quality and appropriateness requirements.

Responsibilities

What You Will Do

  • Conducts timely scheduled/required utilization reviews for Residential Services sites.
  • Conducts timely and complete quality and appropriateness reviews on a representative sample of treatment records for residential service sites.
  • Attends monthly/other require UR Committee meetings. Prepares accurate and timely UR Committee minutes and reports. Participates in the agency's Quality Improvement / Utilization Management Committee.
  • Provides Supervisory support to CASAC Counselors and Peer Workers as needed with supervisory guidance from Management/Leadership Team.
  • Monitors and evaluates ongoing audit for chart.
  • Provides direct care services to clients as needed.
  • Assists with the maintenance of the agency's OASAS accreditation for the program, i.e., standards review and conformance auditing.
  • Performs other duties as assigned.
Qualifications

Who You Will Be

  • High School Diploma or GED required, higher education in the human services field, preferred
  • Current CASAC or the ability to complete requirements to obtain a CASAC (T) within 6 months of hire
  • At least one year of clinical or quality assurance experience in behavioral healthcare/human services organization or one year demonstrated clinical experience in substance use or mental health treatment
  • In depth knowledge on HIPAA, OASAS, and 42 CFR regulations
  • Working knowledge of quality assurance and utilization review systems
  • Proficient in Microsoft Office Suite and EHR systems.
  • Experience working with people from diverse racial, ethnic, and socioeconomic backgrounds.
  • Strong written, verbal, and interpersonal communication skills.
  • Ability to accurately document records according to program standards.
  • Ability to work independently.
  • Spanish bilingual skills are a plus.

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Employment Type: FULL_TIME

What Samaritan Daytop Village employees say

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