Utilization Management (UM) Coordinator – (IDD)
About The Position
Trillium Health Resources is seeking a Utilization Management (UM) Coordinator to manage the administrative aspects of the clinical review process for service authorization requests. This role primarily focuses on Innovations Waiver services for Intellectual/Developmental Disabilities (IDD), as well as Behavioral Health (BH)/Mental Health (MH), and Substance Use (SU) services. The UM Coordinator will pre-screen requests for completeness and compliance with the Trillium Benefit Plan and Clinical Coverage Policies, ensuring they are ready for clinical review. This position involves collaboration with Utilization Management (UM) Clinicians to ensure documentation accuracy, track review timelines and outcomes, communicate decisions to providers, and issue required notifications.
Requirements
- High School Diploma/GED and six (6) years’ experience working in the BH/MH/SU/IDD field; OR Associate’s degree in Human Services, Health, or related field and four (4) years’ experience working in the BH/MH/SU/IDD field; OR Bachelor’s degree in Human Services, Health, or related field and two (2) years’ experience working in the BH/MH/SU/IDD field; OR Equivalent combination of education/experience.
- Must have a valid driver’s license.
- Must reside within North Carolina.
- Must be able to travel within catchment as required.
Nice To Haves
- Experience working with the IDD/BH/MH/SU/ population.
- Experience with individuals with IDD/TBI/Autism as a family member, guardian, community member, or professional.
- Experience providing Innovations Waiver services or other IDD services.
- Experience with care coordination and/or tailored care management inclusive of Individual Support Plan development and person-centered care.
Responsibilities
- Review and pre-screen IDD/MHSU service authorization requests.
- Manage and monitor the timeliness of clinical reviews.
- Coordinate and oversee the submission of clinical documentation.
- Track Peer Reviewer decisions and independently communicate outcomes to clinicians.
- Ensure all required notices and actions are issued appropriately and on time.
Benefits
- Competitive benefits
- Work-from-home options 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
- 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
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
