Senior Utilization Management Specialist MH/SU (Remote)

Trillium Health Resources; North Carolina; Hybride; USD 69 000 - 92 000; Plein temps

Avantages offerts par ce poste

Work-from-home options

Health Insurance with no premium for员工

401k with 5% employer match and vest

PSLF qualifying employer

PTO and holidays

Remote work supplies stipend

Résumé du poste

Trillium Health Resources in North Carolina is seeking a Utilization Management Specialist III - MH/SU to join our team. You will perform comprehensive clinical reviews for mental health, substance use, and related conditions, advise on levels of care, and support providers with guidance and documentation.

This remote role offers standard work hours, strong benefits, and the chance to impact lives across our 46 counties.

Qualifications

• Master's degree in health and human services or related field required.
• Active North Carolina licensure as listed (LCSW, LCMHC, LMFT, LPA, LCAS, RN) required.
• Must reside within North Carolina and be able to travel within catchment.

Responsabilités

• Provide clinical review of services for members with mental health, substance use, and/or developmental disabilities including diagnosis review and medical necessity criteria.
• Determine member eligibility and level of care needed and make service authorization decisions with clear documentation.
• Provide clinical triage for members seeking services and offer consultation to providers.
• Provide ongoing review and staffing regarding treatment documentation for group, family, or individual services.

Formation

Master's degree in health and human services or related field

Description du poste

Trillium Health Resources in North Carolina is seeking a Utilization Management Specialist III - MH/SU to join our team. You will perform comprehensive clinical reviews for mental health, substance use, and related conditions, advise on levels of care, and support providers with guidance and documentation.

This remote role offers standard work hours, strong benefits, and the chance to impact lives across our 46 counties.