Manager, Utilization Management – IDD/MH/SU

🕒 Ontem

🌲 North Carolina – Remoto

🌲 North Carolina – Remote

💵 $78.624 - $105.158 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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Trillium Health Resources

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🏥 Saúde

💼 Consultoria

📦 Logística

Healthcare • Consulting • Logistics

A Trillium Health Resources é uma gestora líder em cuidados especializados (LME/MCO) para indivíduos com sérios problemas de saúde comportamental, deficiências intelectuais/desenvolvimentais e lesão cerebral traumática na Carolina do Norte. A organização está comprometida em investir na saúde e bem-estar das comunidades que atende, fornecendo serviços como triagens de saúde preventiva, intervenção em crises e gestão de cuidados personalizada. A Trillium foca em melhorar o acesso aos serviços de saúde mental e uso de substâncias para seus membros e garantir apoio para populações vulneráveis.

Descrição

• Lead day-to-day utilization management operations • Oversee staff responsible for authorization and clinical review workflows • Monitor performance and guide staff decision-making • Manage workflow execution to ensure timely, accurate determinations and consistent application of review standards • Oversee daily authorization workflows, including intake, review coordination, and determination processing • Assign work and manage staff workload to ensure timely completion of authorization activities • Monitor turnaround times, decision accuracy, and documentation quality across the team • Review cases and decisions to ensure consistent application of clinical criteria and policies • Provide clinical guidance and direction to staff on complex or escalated authorization issues

🎯 Requisitos

• Associate's degree in health, human services, or related field and three (3) years of progressive experience providing utilization management services to the MH/SU/IDD population; OR Bachelor's degree in health, human services, or related field and one (1) year of progressive experience providing utilization management services to the MH/SU/IDD population; OR Master's degree and one (1) year of progressive experience providing utilization management services to the MH/SU/IDD population; OR Equivalent combination of education and experience. • 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 • Must be legally authorized to work in the United States without requiring sponsorship for employment now or in the future • Master’s degree with licensure preferred • Resume must include employer name, dates of service, average hours worked per week, and essential job duties • Application must include education details, including degree type, date awarded, institution, and field of study • Licensure/certification information must be included if applicable • Must pass a drug test as a condition of employment

🏖️ Benefícios

• A collaborative, mission-driven work environment • Competitive benefits and work-from-home options for most positions • Opportunities for professional growth in a diverse inclusive culture • Flexible work schedules available for some positions with management approval • Work-from-home options available for most positions • 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

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