Utilization Management Coordinator – MH/SU

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🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $56.3k - $69.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Trillium Health Resources

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

Healthcare Insurance • Mental Health • Substance Use

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

• Review and pre-screen MHSU service authorization requests. • Manage and monitor the timeliness of clinical reviews. • Coordinate and oversee the submission of clinical documentation. • Track Peer Reviewer decisions and independently communicate outcomes to clinicians. • Ensure all required notices and actions are issued appropriately and on time.

🎯 Requirements

• High School Diploma/GED and six (6) years’ experience working in the BH/MH/SU/IDD field; OR Associate’s degree in Human Services, Health, or related field and four (4) years’ experience working in the BH/MH/SU/IDD field; OR Bachelor’s degree in Human Services, Health, or related field and two (2) years’ experience working in the BH/MH/SU/IDD field; OR Equivalent combination of education/experience. • Must have a valid driver’s license. • Must reside within North Carolina. • Must be able to travel within catchment as required.

🏖️ Benefits

• 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