I/DD Utilization Management Reviewer – Remote

🕒 May 4

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

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Partners Health Management

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2012

⚕️ Healthcare Insurance

Healthcare Insurance • Health Care • Mental Health

Partners Health Management is a local management entity and managed care organization that focuses on providing essential mental health services, supports for individuals with intellectual and developmental disabilities, and substance use disorder services. Their mission is to assist members and their families in accessing the necessary care and resources to improve their overall well-being and integration into the community.

📋 Description

• Facilitate the review of service plans and service authorization requests to ensure individuals receive appropriate services • Review authorization requests for completeness • Approve some requests based on an algorithm for auto-approval • Refer requests for medical necessity review by Licensed Utilization Management Reviewers • Administratively deny incomplete requests • Onboarding/training/mentoring of new staff as requested by leadership • Other duties as needed to support the Supervisor, Manager, and Director.

🎯 Requirements

• A Bachelor’s Degree in a Human Services field and two (2) years of post-degree I/DD experience • Comprehensive knowledge of mental illness and diagnostic categories • Knowledge of the assessment and treatment of developmental disabilities, with or without co-occurring mental illness • Knowledge of the 1915 (b) (c) waiver • Knowledge of psychiatric medications and side effects • Knowledge of evidence based practices • Knowledge of appropriate treatments for major diagnostic categories • Exceptional interpersonal skills, highly effective communication ability • Propensity to make prompt independent decisions based upon relevant facts and established processes • Problem solving, negotiation and conflict resolution skills • Awareness of cultural diversity • Excellent computer skills including proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc) • Ability to make prompt decisions based on relevant facts • Detail oriented, able to independently organize multiple tasks and priorities, and effectively manage an assigned caseload under pressure of deadlines.

🏖️ Benefits

• Competitive Compensation & Benefits Package! • Annual incentive bonus plan • Medical, dental, and vision insurance with low deductible/low cost health plan • Generous vacation and sick time accrual • 12 paid holidays • State Retirement (pension plan) • 401(k) Plan with employer match • Company paid life and disability insurance • Wellness Programs • Public Service Loan Forgiveness Qualifying Employer • See attachment for additional details.