Behavioral Health Utilization Management Specialist

Barrycountyrecovery; Hastings (MI); On-site; USD 52,625 - 64,320; Full time

Benefits offered by this job

Four-day work week

Flexible scheduling

Collaborative team culture

Opportunities for professional growth

Job summary

Barrycountyrecovery is seeking a detail-oriented Behavioral Health Utilization Management Specialist. This position involves reviewing behavioral health services to ensure compliance and appropriateness of care levels.

The role offers a primarily remote environment, with optional four-day work weeks catering to work-life balance, aligning with our collaborative, mission-driven culture.

Candidates should hold a Master's degree in a related field and have active licensure in Michigan. We are committed to diversity, equity, and inclusion in our workplace.

Qualifications

• Master’s degree in Social Work, Professional Counseling, Psychology, or a related field.
• Current, active licensure in the State of Michigan.
• Prior experience in utilization management or managed care is required.
• Strong attention to detail and critical thinking skills.
• Excellent written and verbal communication abilities.

Responsibilities

• Conduct utilization reviews for behavioral health services.
• Assess clinical documentation for medical necessity and level of care.
• Ensure compliance with regulations and guidelines.
• Collaborate with providers and care teams.
• Maintain accurate and timely documentation of UM activities.
• Participate in audits and quality improvement initiatives.

Skills

Attention to detail

Critical thinking

Communication skills

Ability to work independently

Education

Master's degree in Social Work, Counseling, Psychology or related field

Current licensure in the State of Michigan

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time Hastings, MI, US

4 days ago Requisition ID: 1174

Salary: $58,473.00 Annually

Location: Primarily Remote (Michigan-based)

Schedule: Full-Time | Option for Four-Day Work Week

Position Overview: We are seeking a detail-oriented and clinically skilled Behavioral Health Utilization Management (UM) Specialist to join our team. This role is responsible for reviewing behavioral health services to ensure medical necessity, regulatory compliance, and appropriate level of care determinations. The ideal candidate brings strong clinical judgment, experience with managed care or utilization management processes, familiarity with Community Mental Health/CMHSP operations, and the ability to work independently in a remote environment.

Key Responsibilities:

• Conduct utilization reviews for behavioral health services, including initial, concurrent, and retrospective reviews
• Assess clinical documentation to determine medical necessity and appropriate level of care
• Ensure compliance with state, federal, and payer-specific regulations and guidelines
• Collaborate with providers, care teams, and internal stakeholders to support quality service delivery
• Maintain accurate and timely documentation of all UM activities
• Participate in audits, quality improvement initiatives, and process enhancements
• Stay current on best practices, regulatory updates, and industry standards in behavioral health and managed care

Qualifications:

• Master’s degree in Social Work, Professional Counseling, Psychology, or a related behavioral health field
• Current, active licensure in the State of Michigan (e.g., LMSW/LLMSW, LPC/LLPC, LLP/TLLP)
• Prior experience in utilization management, managed care, or similar review functions required
• Strong attention to detail and critical thinking skills
• Excellent written and verbal communication abilitiesAbility to work independently while managing multiple priorities

Preferred Qualifications:

• Experience with behavioral health payer guidelines and authorization processes
• Familiarity with electronic health records and UM software systems

What We Offer:

• Four-day work week promoting work-life balance
• Primarily remote work environment with flexible scheduling
• Collaborative and mission-driven team culture
• Opportunities for professional growth and development

How to Apply: Interested candidates should submit a resume and cover letter outlining their relevant experience and licensure status.

We are an equal opportunity employer committed to diversity, equity, and inclusion in the workplace.