Manager, Utilization Management – IDD/MH/SU

🔥 7 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $78.6k - $105.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Trillium Health Resources

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Trillium Health Resources is a leading specialty care manager (LME/MCO) for individuals with serious behavioral health, intellectual/developmental disabilities, and traumatic brain injury in North Carolina. The organization is committed to investing in the health and well-being of the communities it serves, providing services such as preventive health screenings, crisis intervention, and tailored care management. Trillium focuses on enhancing access to mental health and substance use services for its members and ensuring support for vulnerable populations.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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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