Utilization Review Specialist (26-144)
Kent County CMH Authority
Summary
Network180 is the behavioral health community organization responsible for the delivery of mental health, substance abuse treatment coordination, and developmental disabilities services for Kent County. We are seeking a Utilization Review Specialist to perform utilization review of intellectual and developmental disability services (I/DD), mental health, and substance use disorder (SUD) intensive treatment services.
Job description
This position will assess individuals' current or proposed treatment plan to identify and address potential barriers to discharge and assist in transitioning care to an appropriate intensity service setting. This position is full-time, Monday through Friday, from 8:00am to 4:30pm. There are no weekends, on-call or holiday requirements for this position. While the position is remote, the individual in this position will have occasional travel within the Kent County community and surrounding areas.
Minimum Qualifications
- 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.
- May need to work an occasional weekend day or holiday depending on volume of utilization reviews scheduled to be completed.
- Ability to work effectively in a multicultural environment and skills and capabilities of bridging language/cultural barriers to Network180 services within diverse communities.
Preferred Qualifications
- 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.
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
- 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
- Experience performing utilization review and/or providing clinical services in an intensive treatment setting (preferred)
- Qualified Intellectual Disability Professional (QIDP) (preferred)
- Child Mental Health Professional (CMHP) (preferred)
Benefits
- Health Insurance
- Dental & Vision Insurance
- 13 Paid Holidays
- Generous PTO
- Professional Development
- Tuition Reimbursement
- Professional License Reimbursement
- Defined Contribution Retirement Plan
- Employee Assistance Program
- Life Insurance
- Short & Long Term Disability
- Loan Forgiveness
Company overview
Kent County CMH Authority is a community mental health organization serving residents of Kent County, Michigan. As a public mental health authority, it provides comprehensive behavioral health services to individuals with mental health conditions, developmental disabilities, and substance use disorders. The organization operates under Michigan's public mental health system and is responsible for coordinating and delivering essential mental health services to the local community. Kent County CMH Authority focuses on providing accessible, community-based care that includes crisis intervention, outpatient therapy, case management, residential services, and support programs for individuals and families. The authority works to promote mental wellness, prevent mental health crises, and support recovery through evidence-based practices and person-centered approaches. It collaborates with various community partners, healthcare providers, and social service agencies to create an integrated system of care that addresses the diverse needs of the population it serves.