Utilization Review Manager Jobs in Rochester, MN

This position requires someone who has had a Driver's License for at least 1 year (post-permit) and a clean driving record that meets Sevita’s insurability policy.

• Position Type: Full-time, non-exempt, hourly supervisor role.
• Scope of Role:
  • Supervises a single program or unit within a program, typically supporting 4-8 individuals in residential settings or 10-15 individuals in periodic, vocational or day programs. Duties are split between the provision of direct support, professional or program activities and supervision.
• Key Responsibilities:
  • Supervise Direct Support Professionals
  • Oversee the day-to-day operation of the program including delivery of supports, implementation of person-centered plans, health care, advocacy, customer engagement, regulatory compliance and when applicable, oversight of the physical environment.
  • Generally works 8 to 16 flexible hours per week in a supervisory capacity; and provides direct support for the remaining hours.

ESSENTIAL JOB FUNCTIONS

To perform this job successfully, an individual must be able to satisfactorily perform each essential function listed below.  

1. Direct Support: Works regularly scheduled shifts as a direct support professional (see DSP position description).
2. Records: Documents as required; reviews individual records, billing and other program documentation routinely for accuracy and completion on a daily basis; maintains
3. Program Planning: Assists the Program Director in development of individual program plans; trains and monitors implementation of plans each day across all shifts.
4. Team Meetings: Attends and assists with routine progress meetings.
5. Compliance: Assists the Program Director in maintaining licensing compliance for program services and supports; implements Sevita compliance plan; manages individual rights implementation.
6. Management of Individuals’ Assets: When assigned, assures safety of individual’s funds and property; monitors spending and reconciles individual’s financial accounts monthly.
7. Incidents: Completes or assists DSPs in documenting incident reports; submits initial incident reports to the Program Director.
8. Billing and Utilization: Compiles or accumulates census or attendance information; reviews data and attests to accuracy; submits accurate data to the Program Director or appropriate billing authority.

1. General Health Care: Monitors health of persons being served; documents; communicates with medical professionals as appropriate; implements preventive strategies to limit illness and serious incidents; reviews and monitors documentation across all shifts.
2. Appointments: When applicable, schedules or assists in scheduling health care appointments; may accompany individuals to appointments; may assist with communication; documents visits; oversees follow through of orders; communicates results as appropriate with families, guardians, case managers, day programs or others.
3. Medications: When applicable, accurately administers or supports self-administration of medication and documents delivery of medications and treatments; reviews all other medication documentation for accuracy and completeness, daily or weekly as required; reviews medication errors with employees; communicates medication changes and provides training across all shifts; maintains appropriate security of medications and supplies.
4. Medical Supplies and Equipment: Purchases and maintains medical supplies and equipment in consultation with Program Director; communicates with employees and may assist with training on proper use.
5. Dietary planning: Develops menus based on diets, preferences, and occasions, and with the exception of some in-home services, purchases or oversees purchasing of food and supplies in accordance with planned menus and individual choice or need; directs and monitors food service, consistent with individual plans.

1. Communications: Maintains productive and professional relations with individuals, families, case managers and other stakeholders.
2. Customer Service: Implements Sevita Customer Service Standards; trains DSPs in delivery.

1. Recruitment and Hiring: As needed, assists with recruitment; interviews and hires direct support professionals in consultation with the Area Director and Talent Acquisitions teams.
2. Employee Scheduling: Populates and maintains schedule to assure that all shifts are covered, and overtime is minimized.
3. Training: Assists with onboarding and delivers orientation and ongoing training concerning the individuals served, program plans, policies, procedures and physical environment; Verifies training records are accessible in the home and are completed by all staff on the schedule.
4. Evaluation: Prepares and conducts annual evaluations for Direct Support Professionals, in consultation with the Program Director.
5. Discipline and Termination: Coaches employees as needed, correcting or directing employee behavior where required; may remove employees in the event of emergency; may recommend and participate in decisions regarding termination; consults with the Program Director on all matters of discipline.
6. Employee Safety: Responsible for employee safety and workers’ compensation within the program; implements and monitors compliance with safety standards.
7. Management: May assist with or lead monthly program meetings for direct support professionals; documents monthly meeting agenda and attendance.

1. Purchasing: When applicable, purchases food and household supplies; purchases office supplies and minor equipment; reviews and attests company credit card statements and monthly invoices; directs employees as necessary; monitors and attests to cost effective, accurate and applicable spending.
2. Individuals’ Served Funds Management: Secures and safeguards individuals' served funds locally; uses forms for money/debit card transfers; updates financial ledgers weekly and maintains itemized receipts for purchases on behalf of individuals served
3. Billing and Utilization: Reviews census, attendance information or other required documentation to assure accurate billing; monitors utilization between authorization and provision of services and supports.
4. Staffing: Monitors staffing hours for budgetary compliance.

1. Census Capture: Captures daily census within systems; understands importance of accurate and timely service capture along with required documentation.
2. Census Performance: Develops basic understanding of census, including how census is measured and census performance for locations; Escalates potential service disruptions
3. Placements: Supports location preparations required for expected placements (e.g., room & furniture set-up, safety requirements, etc.).

1. Vehicles: When applicable, test drives vehicle monthly; inspects vehicle lifts and seatbelts monthly; reports safety concerns immediately to supervisor or maintenance personnel; assures vehicle is washed and cleaned; trains staff in safe vehicle operation and safely transporting individuals; ensures routine maintenance is performed.
2. Living Environment: When applicable, schedules and monitors daily and seasonal housekeeping; oversees lawn and yard care. Maintains neat, clean and safe environment for individuals served.
3. Maintenance and Repair: When applicable, makes or arranges for minor repairs; reports to and schedules repairs by maintenance personnel as required; monitors environmental safety; monitors water temperature, refrigerator and freezer temperature, and safety alarms and extinguishers on a monthly basis; replaces furnace filters monthly.
4. Equipment: Monitors wheelchairs, lifts and other safety equipment; sees that repairs are made promptly and correctly in the event of faulty equipment.

• Performs other duties and activities as required, including backfilling roles under your supervision.
• MPA = Mobile Punch Authorized for timekeeping.

SUPERVISORY RESPONSIBILITIES

• Supervises the Direct Support Professionals.
• Manages assigned personnel. Completes performance evaluations, orientation, and training. Makes decisions on employee hires, transfers, promotions, salary changes, discipline, terminations, and similar actions. Resolves employee problems within position responsibilities.

Minimum Knowledge and Skills required for the Job

The requirements listed below are representative of the knowledge, skill, and/or abilities required to perform the job.

Education and Experience: 

• High School diploma or equivalent
• One-year related work experience
• Must be 18 years or older.
• Working knowledge of computers

Certificates, Licenses, and Registrations:

• Current driver's license, car registration and auto insurance if driving on the behalf of the Company or providing transportation to individuals receiving services.
• Other licensure(s) or certification(s) where required by regulatory authority.

• Provides and oversees services or supports in residential, vocational, or in-home settings.
• The Program Supervisor works at the program location and is generally expected to visit each shift and all employees at least one time per month, including supervising periodic or hourly services.

Physical Requirements:

• Heavy work.  Exerting up to 100 pounds of force occasionally, and/or up to 50 pounds of force frequently, and/or up to 20 pounds of force constantly to move objects.

• CS New Jersey – Refer to: CS NJ Addendum – Program Supervisor _2845 _ MPA 3431