Utilization Review Specialist (26-61)

Kent County CMH Authority • Grand Rapids, MI

13h • Remote

About The Position

Network180 is a behavioral health community organization responsible for the delivery of mental health, substance abuse treatment coordination, and developmental disabilities services for Kent County. The organization seeks individuals passionate about helping others. This Utilization Review Specialist position involves performing utilization review of intellectual and developmental disability services (I/DD), mental health, and substance use disorder (SUD) intensive treatment services. The specialist will assess individuals’ current or proposed treatment plans to identify and address potential barriers to discharge and assist in transitioning care to an appropriate intensity service setting.

Requirements

• Fully licensed Master of Social Work (LMSW), fully licensed Marriage and Family Therapist (LMFT), fully licensed Professional Counselor (LPC); or limited licensed Psychologist (LLP), with at least five (5) years of clinical experience (at least two [2] years of clinical experience post-licensure preferred); or Registered Nurse (RN) in Michigan with at least two (2) years of clinical experience in the delivery of behavioral health services
• Ability to interpret clinical summaries and apply established medical necessity criteria to make utilization decisions
• Thorough working knowledge of the practices and principles of psychological, emotional, and sociological assessment and diagnosis
• Thorough working knowledge of professional ethics and standards of practice
• Ability to handle multiple projects simultaneously
• Lived experiences with mental illness/developmental disabilities/substance use disorders valued
• Computer skills including word processing, spreadsheets, email, database management, and data entry skills
• Ability to work in a fast-paced environment
• Ability to communicate clearly and concisely in stressful situations
• Excellent communication skills, both verbal and written
• Ability to work effectively in a multicultural environment and skills and capabilities of bridging language/cultural barriers to Network180 services within diverse communities

Nice To Haves

• Experience performing utilization review and/or providing clinical services in an intensive treatment setting
• Qualified Intellectual Disability Professional (QIDP; requires one-year full time experience working with persons with developmental disabilities and appropriate license/degree per State of Michigan), preferred for positions reviewing intellectual and developmental disability services
• Child Mental Health Professional (CMHP; requires one year of experience in the examination, evaluation, and treatment of minors and their families and appropriate license/degree per State of Michigan), preferred for positions reviewing children’s services

Responsibilities

• Perform utilization review of intellectual and developmental disability services (I/DD), mental health, and substance use disorder (SUD) intensive treatment services
• Assess individuals’ current or proposed treatment plan to identify and address potential barriers to discharge
• Assist in transitioning care to an appropriate intensity service setting

Benefits

• Four health insurance plans
• 100% employer paid dental and vision insurance plans
• 13 paid holidays
• Generous PTO
• Professional development
• Tuition reimbursement
• Professional License reimbursement
• Defined contribution retirement plan
• Employee Assistance program
• Life and voluntary life insurance options
• Short and Long term disability
• Approved site for loan forgiveness (based on position and department): NHSC, STAR Loan Repayment, Behavioral Health Loan Repayment, MI Kids Now Loan Repayment and much more!

What This Job Offers

• Job Type: Full-time
• Career Level: Senior