Utilization Management Specialist III – MH/SU

Job not on LinkedIn

🔥 2 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $68.9k - $92.1k / year

⏰ Full Time

🟢 Junior

👻 Ghost score 0%

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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

• Provide comprehensive clinical review of service requests for people experiencing psychiatric symptoms related to mental health issues, substance use, developmental disabilities, or co-occurring conditions • Review diagnoses, medical necessity criteria, member eligibility, and level of care needs • Make service authorization decisions with timely, clear, concise documentation • Provide clinical triage for members seeking services through Screening, Triage and Referral • Provide consultation and technical assistance to providers regarding clinical care needs, levels of care, Client Rights Rules, evidence-based practices, and scope-of-practice issues • Conduct ongoing review, staffing, and consultation of treatment documentation for members participating in group, family, or individual services

🎯 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: 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 • Preferred: A minimum of two (2) years of post-Master's experience in a clinical setting with the BH/MH/SU/IDD population • All candidates must pass a drug test as a condition of employment • Resume must include employer name, dates of service, average hours worked per week, essential job duties, education details, and licensure/certification information if applicable

🏖️ Benefits

• A collaborative, mission-driven work environment • Competitive benefits • Work-from-home options for most positions • Opportunities for professional growth in a diverse inclusive culture • Flexible work schedules with some roles 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