[Hiring] I/DD Utilization Management Reviewer @Partners Behavioral Health Management

Role Description

This position is responsible for facilitating the review of service plans and service authorization requests to ensure that individuals are receiving the most appropriate services at a given time.

• Review of Service Plans and Authorization Requests to ensure that all required documents are submitted
• Approve requests based on an algorithm for “auto approval” of the plan and authorization requests
• Refer plan and authorization requests that cannot be “auto approved” to Licensed Utilization Management Reviewer for medical necessity review
• Administratively deny incomplete requests
• Onboarding/training/mentoring of new staff as requested by leadership
• Other duties as needed to support the Supervisor, Manager, and Director

Qualifications

• Comprehensive knowledge of mental illness and diagnostic categories
• Knowledge of the assessment and treatment of developmental disabilities, with or without co-occurring mental illness
• Knowledge of the 1915 (b) (c) waiver
• Knowledge of psychiatric medications and side effects
• Knowledge of evidence-based practices
• Knowledge of appropriate treatments for major diagnostic categories
• Exceptional interpersonal skills and highly effective communication ability
• Problem solving, negotiation, and conflict resolution skills
• Awareness of cultural diversity
• Excellent computer skills including proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc)
• Detail oriented, able to independently organize multiple tasks and priorities

Requirements

• A Bachelor’s Degree in a Human Services field
• Two (2) years of post-degree I/DD experience

Benefits

• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
• Public Service Loan Forgiveness Qualifying Employer