Utilization Management (UM) Coordinator – (MH/SU)
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 related to Behavioral Health (BH)/Mental Health (MH), and Substance Use (SU) services. This role involves pre-screening requests for completeness and compliance with the Trillium Benefit Plan and Clinical Coverage Policies, ensuring they are ready for clinical review. The UM Coordinator will collaborate with Utilization Management (UM) Clinicians, oversee documentation accuracy, track review timelines and outcomes, communicate decisions to providers, and ensure necessary notifications are issued correctly.
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 BH/MH/SU/IDD population.
- Experience with child MH/SU services and/or inpatient experience
Responsibilities
- Review and pre-screen 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
