Utilization Review Specialist

🔥 5 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $63.1k - $83.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Network180 - Kent County Community Mental Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1974

🏥 Healthcare

🤝 Non-profit

🌍 Social Impact

Healthcare • Non-profit • Social Impact

Network180 - Kent County Community Mental Health is a county-based behavioral health organization that provides public mental health and substance use services to residents of Kent County. It operates crisis intervention, outpatient therapy, case management, care coordination, and community outreach programs, and partners with schools, law enforcement, and healthcare providers to improve access to care and support recovery. Network180 functions as a local community mental health authority focused on prevention, treatment, and community-based supports.

📋 Description

• Perform utilization review of intellectual and developmental disability services, mental health, and substance use disorder intensive treatment services • Assess individuals’ current or proposed treatment plans • Identify and address potential barriers to discharge • Assist in transitioning care to an appropriate intensity service setting • Work full-time Monday through Friday, 8:00am to 4:30pm • Potentially work an occasional weekend day or holiday depending on utilization-review volume • Travel occasionally within the Kent County community and surrounding areas • Communicate and bridge language/cultural barriers to Network180 services within diverse communities • Participate in interviews conducted in person or via the internet

🎯 Requirements

• Fully licensed Master of Social Work (LMSW), fully licensed Marriage and Family Therapist (LMFT), fully licensed Professional Counselor (LPC); or limited licensed Psychologist (LLP), with at least five (5) years of clinical experience (at least two [2] years of clinical experience post-licensure preferred) • Or Registered Nurse (RN) in Michigan with at least two (2) years of clinical experience in the delivery of behavioral health services • Ability to interpret clinical summaries and apply established medical necessity criteria to make utilization decisions • Thorough working knowledge of the practices and principles of psychological, emotional, and sociological assessment and diagnosis • Thorough working knowledge of professional ethics and standards of practice • Ability to handle multiple projects simultaneously • Computer skills including word processing, spreadsheets, email, database management, and data entry skills • Ability to work in a fast-paced environment • Ability to communicate clearly and concisely in stressful situations • Excellent communication skills, both verbal and written • Ability to work effectively in a multicultural environment and bridge language/cultural barriers to Network180 services within diverse communities • Successful completion of a drug screen as part of the background check process • Must comply with Network180's drug and alcohol-free workplace policy, including prohibition of recreational marijuana use • QIDP preferred for positions reviewing intellectual and developmental disability services; requires one-year full-time experience working with persons with developmental disabilities and appropriate license/degree per State of Michigan • CMHP preferred for positions reviewing children's services; requires one year of experience in examination, evaluation, and treatment of minors and their families and appropriate license/degree per State of Michigan

🏖️ Benefits

• Four health insurance plans • 100% employer paid dental and vision insurance plans • 13 paid holidays • Generous PTO • Professional development • Tuition reimbursement • Professional License reimbursement • Defined contribution retirement plan • Employee Assistance program • Life and voluntary life insurance options • Short and Long term disability • Approved site for loan forgiveness (based on position and department): NHSC, STAR Loan Repayment, Behavioral Health Loan Repayment, MI Kids Now Loan Repayment and much more! • No weekends, on-call or holiday requirements for this position • Remote work arrangement • Equal opportunity employment • Reasonable accommodations for individuals with disabilities