Utilization Management Specialist III – MH/SU

Job Description:

• Provide comprehensive clinical review of service requests for people experiencing psychiatric symptoms related to mental health issues, substance use, developmental disabilities, or co-occurring conditions
• Review diagnoses, medical necessity criteria, member eligibility, and level of care needs
• Make service authorization decisions with timely, clear, concise documentation
• Provide clinical triage for members seeking services through Screening, Triage and Referral
• Provide consultation and technical assistance to providers regarding clinical care needs, levels of care, Client Rights Rules, evidence-based practices, and scope-of-practice issues
• Conduct ongoing review, staffing, and consultation of treatment documentation for members participating in group, family, or individual services

Requirements:

• Master's degree in health and human services or related field
• One (1) year of experience providing Utilization Management services
• Active North Carolina licensure as: Licensed Clinical Social Worker (LCSW), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Marriage and Family Therapist (LMFT), Licensed Psychological Associate (LPA), Licensed Clinical Addictions Specialist (LCAS), or Registered Nurse (RN)
• Must have a valid driver's license
• Must reside within North Carolina
• Must be able to travel within catchment as required
• Preferred: A minimum of two (2) years of post-Master's experience in a clinical setting with the BH/MH/SU/IDD population
• All candidates must pass a drug test as a condition of employment
• Resume must include employer name, dates of service, average hours worked per week, essential job duties, education details, and licensure/certification information if applicable

Benefits:

• A collaborative, mission-driven work environment
• Competitive benefits
• Work-from-home options for most positions
• Opportunities for professional growth in a diverse inclusive culture
• Flexible work schedules with some roles with management approval
• Health Insurance with no premium for employee coverage
• Flexible Spending Accounts
• 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
• NC Local Government Retirement Pension (defined-benefit plan)
• 401k with 5% employer match and immediate vesting
• Public Service Loan Forgiveness (PSLF) qualifying employer
• Quarterly stipend for remote work supplies