Utilization Review Specialist
We are seeking a full-time Utilization Review Specialist to perform utilization review of developmental disability services, mental health and substance abuse intensive treatment services. Assess individuals’ current or proposed treatment plan to identify and address potential barriers to discharge and assist in transitioning care to a lower intensity service setting.
The person in this position will be assigned to review adult behavioral health services as well as intellectual and developmental disability services.
- Licensed Master of Social Work (LMSW), Limited Licensed Psychologist (LLP), Licensed Marriage and Family Therapist (LMFT), or Licensed Professional Counselor (LPC) with at least 5 years of clinical experience (2 years of clinical experience post licensure preferred); or
- Registered Nurse (RN) with at least 2 years of clinical experience in delivery of health services.
- Experience in performing utilization review and/or providing clinical services in an intensive treatment setting is preferred.
- Experience providing behavioral health services in an intensive community-based setting preferred.
- 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 at one time
- 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
For a detailed job description, responsibilities and information on how to apply directly through our website, please visit www.network180.org.
Network180 is an Equal Opportunity Employer. Network180 participates in E-Verify.