Company Overview Pathway to Hope Counseling Services, Inc. is dedicated to providing high-quality mental health services across multiple counties. Our team includes licensed therapists, registered nurses, psychologists, and psychiatrists committed to making a meaningful difference in the lives of children and adults through comprehensive care. Job Overview We are seeking a detail-oriented and knowledgeable Clinical Documentation & Utilization Review Specialist to join our dynamic healthcare team. This role provides first-level clinical and compliance review of assessments, treatment plans, diagnostic documentation, SAFE-T, OTRs, and related clinical records. The position ensures documentation is complete, internally consistent, timely, and compliant with agency, payer, Medicaid, and contractual requirements before submission for final Clinical Director signature when required. This position does not replace the Clinical Director or independently licensed clinician when final clinical approval, supervision, or signature is required. The Clinical Documentation & Utilization Review Specialist may review, identify deficiencies, request corrections, and recommend that documentation is ready for final review. Minimum Qualifications Master's degree in social work, Counseling, Psychology, Marriage and Family Therapy, or a related behavioral health/clinical field. Clinical experience in behavioral health, mental health, child welfare, substance use, or a related setting. Working knowledge of behavioral health assessments and treatment planning. Ability to interpret diagnoses, clinical recommendations, goals, objectives, interventions, and medical-necessity documentation. Experience with Medicaid/managed-care documentation requirements preferred. Strong attention to detail and ability to provide clear corrective feedback to clinical staff. Duties and Responsibilities Conduct the initial clinical documentation review of assessments, diagnostic evaluations, treatment plans, treatment-plan reviews, and other designated clinical records Review assessments for completeness and identify missing clinical information, required sections, supporting documentation, or assessment instruments. Maintain confidentiality and comply with HIPAA and all applicable organizational, contractual, Medicaid, and regulatory requirements. Participate in internal quality assurance, utilization management, chart review, and compliance activities. Provide staff education and feedback regarding documentation standards and recurring documentation errors. Monitor documentation deadlines and notify appropriate staff of outstanding or overdue clinical documentation. Identify discrepancies, omissions, conflicting information, incorrect dates, missing signatures, incorrect credentials, or other documentation deficiencies. Return deficient documentation to the appropriate clinician with specific corrective feedback and track corrections through completion. Join our team as a Clinical Documentation & Utilization Review Specialist to ensure the delivery of high-quality patient care through precise documentation practices while supporting regulatory compliance and efficient resource utilization!

Pay:

$20.00 - $22.00 per hour

Benefits:

Dental insurance Health insurance Vision insurance

Work Location:

In person