Manager, Utilization Management – IDD/MH/SU

Trillium Health Resources; North Carolina; Remote; USD 79,000 - 105,000; Full time

Benefits offered by this job

Work-from-home options

Health insurance with no premium

401k with employer match

PTO 24 days + 12 holidays

PSLF eligible employer

Remote work stipend

Job summary

Trillium Health Resources is seeking a Manager, Utilization Management - IDD/MH/SU to lead day-to-day utilization management operations and supervise staff responsible for authorization and clinical reviews. You will ensure timely, accurate determinations and consistent application of review standards, while guiding case decisions and optimizing workflow within North Carolina's care network.

Join a mission-driven organization offering flexible work options, competitive benefits, and

Qualifications

• 3+ years progressive experience providing utilization management services to MH/SU/IDD populations.
• Active North Carolina licensure (LCSW, LCMHC, LMFT, LPA, LCAS, RN).
• Valid driver's license and NC residency.
• Authorized to work in the United States without sponsorship now or in the future.

Responsibilities

• Oversee daily authorization workflows including intake, review coordination and determinations.
• Assign work and manage staff workload for timely authorization activities.
• Monitor turnaround times, decision accuracy and documentation quality.
• Review cases to ensure consistent application of clinical criteria and policies.
• Provide clinical guidance to staff on complex or escalated authorization issues.

Skills

Utilization management

Staff supervision

Clinical review

Decision making

Analytical thinking

Education

Associate's degree in health, human services, or related field

Bachelor's degree in health, human services, or related field

Master's degree in health or related field

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.

Utilization Management Full Time Officials & Admin NC, US 2 Attachments

2 days ago Requisition ID: 3504

Salary Range: $78,624.00 To $105,158.00 Annually

FLSA Status: Exempt

Posting Salary Range: $78,624 - $105,158

Office Location: Remote within North Carolina.

POSTING DETAILS:

Make an Impact

Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.

Why Work for Us?

Trillium believes that empowering others begins with supporting our team. We offer our employees:

• Competitive benefits and work-from-home options for most positions
• Opportunities for professional growth in a diverse inclusive culture

Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.

What We’re Looking For

Trillium Health Resources has a career opening for a Manager, Utilization Management - IDD/MH/SU to join our team! The Manager, Utilization Management leads day-to-day utilization management operations and oversees staff responsible for authorization and clinical review workflows. The role monitors performance, guides staff decision-making, and manages workflow execution to ensure timely, accurate determinations and consistent application of review standards.

On a typical day, you might:

• 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.

Employee Benefits:

Trillium knows that work/life balance is essential. That's why we offer:

• Typical working hours: 8:30 am - 5:00 pm; 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
• 401k with 5% employer match and immediate vesting
• Public Service Loan Forgiveness (PSLF) qualifying employer
• Quarterly stipend for remote work supplies

Qualifications

Required:

• 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)
  • 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 (ex: OPT F-1, J-1).

Preferred:

• Master’s degree with licensure.

Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.

#Innovation #Technology #Careers #NorthCarolina #BehavioralHealth

Attachments (2)

Tips for Applying to or Interviewing with Trillium 10.9.26.pdf