Utilization Review Specialist

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Grand Rapids, MI, US

FTE
:
Full-time, exempt

Unit
: UAW

Compensation: $63,102.73-$83,647.81 The Final job offer is based on several factors (internal equity, skills, education, experience, and credentials).

• 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!

Network
180 employees make a difference in people’s lives every day, making our community a better place to live. We are the behavioral health community organization responsible for the delivery of mental health, substance abuse treatment coordination, and developmental disabilities services for Kent County. We need individuals who are passionate about making a difference by helping others.

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. 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.

• 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 Network
  180 services within diverse communities.

• 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…