Utilization Management Specialist III – IDD

🔥 4 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $68.9k - $92.1k / year

⏰ Full Time

🟢 Junior

👻 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

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

• Perform clinical review of service authorization requests and determine appropriate level of care • Evaluate authorization requests for medical necessity and appropriate level of care • Approve, modify, or recommend denial of services based on clinical criteria and established guidelines • Interpret clinical documentation, diagnoses, and treatment plans • Provide clinical consultation to providers and internal teams regarding service requests • Perform clinical triage and guide referral decisions based on member needs • Participate in appeals, mediations, administrative hearings, and post-service clinical reviews

🎯 Requirements

• Master's degree in health and human services or related field • One (1) year of experience providing Utilization Management services • Active North Carolina licensure as a 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) • Valid driver's license • Must reside within North Carolina • Must be able to travel within catchment as required • Preferred: Two (2) years of post-Master's experience in a clinical setting with the IDD/BH/MH/SU population • Must pass a drug test as a condition of employment • Resume must include employer names, dates of service, average hours worked per week, essential job duties, education details, and licensure/certification information

🏖️ Benefits

• Collaborative, mission-driven work environment • Competitive benefits • Work-from-home options for most positions • Opportunities for professional growth • Flexible work schedules available for some positions with management approval • 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