Image of smiling employees. Banner text: Join the Upstate Team! Forbes 2025 Best Employers

Utilization Review/Quality Assurance Coordinator

  • Syracuse
  • Allied Health
  • Management & Professional
  • Part-time
  • Opening on: Aug 4 2026
  • Psychiatry-Adult Clinic
  • State of New York
  • TH Utilization Review Quality Assurance Coordinator, NSSL3
  • 90565
  • UUP (State University Professional Services Unit)

Job Summary:

The Utilization Review Quality Assurance Coordinator is responsible for all compliance related paperwork and ensures paperwork is completed in a timely manner. Support clinic providers with training and re-education as it relates to Office of Mental Health regulations. Monitor open encounters and report any issues to the Business Manager. Review utilization of services in order to comply with regulatory and institutional requirements. Insure patient care services are appropriately documented and utilized. Review case records to determine if patients are receiving appropriate services and at the correct level of service. 

Minimum Qualifications:

Bachelors degree with 2 years of experience in a mental health or health care related setting OR Associates Degree and 4 years of experience in a mental health or health care related setting required. Excellent communication and customer service skills required for interface with health care providers, payers, regulatory agencies and other health care related entities.

Preferred Qualifications:

Bachelors degree in Social Work or health care related field preferred. Understanding of Office of Mental Health regulations preferred.

Work Days:

Monday-Friday, days

Message to Applicants:

Recruitment Office: Human Resources

We are an Equal Opportunity Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran status or disability or other protected classes under State and Federal law.

Recently Posted Jobs

Registered Nurse - Clinical Leader

Syracuse
CG-Emergency Dept Full-Time (1.0 FTE),  Evening/Night/EOW/ 2/3 Major Holidays

Registered Nurse

Syracuse
Procedural Float Pool Full-Time (1.0 FTE),  Monday-Friday, Days

Outpatient Administrative Specialist

Syracuse
The Outpatient Administrative Specialist will provide clinical administrative support to the assigned ambulatory area.  May assist in the preparation of monthly report of activities by compiling statistical data relative to clinic services as needed or requested. Serves as a subject matter expert and resource for providers and staff, addressing all non-routine issues and concerns related to the referral and authorization process. Assist with patient check-in and check-out procedures including registration activities such as entering and/or verifying demographic, insurance and/or financial information; generates routine forms and other documentation. Manage the EPIC Referral WQs. Answers phone, prioritizes incoming mail, faxes and correspondence. Work with/advise patients on insurance carrier requirements including services not covered and obtains documentation, collects patient co-pays, etc. Applies understanding of the need for ABN's and Waiver of Liability patient signatures. Obtains insurance authorizations, referrals, and manages denial processes in an accurate and efficient manner. Accepts assignments to other areas and performs additional administrative support duties as assigned.