Collaborate with Utilization Management Program Manager to create, review and amend utilization review processes ongoing for all populations. Provide oversight, guidance, and support to clinical and non-clinical staff, ensuring adherence to the Michigan Medicaid Provider Manual, MCG Criteria, all Network180 and LRE policies and established guidelines. Provide support and oversight throughout appeals process as needed. Complete clinical reviews and coordination of care as needed for specified populations and levels of care.
During the COVID-19 pandemic, we are providing as many services as possible through Telehealth. Many employees are able to work from home during this time. For employees who do need to work on-site or see individuals in person, we provide Personal Protection Equipment to our employees and thorough safety and cleaning protocols are in place. Job interviews are being conducted via the internet.
- Licensed Master of Social Work (LMSW), Limited Licensed Psychologist (LLP), or Licensed Professional Counselor (LPC)
- At least 5 years of clinical experience in delivery of behavioral health services
- Demonstrated knowledge of managed care and utilization management practices
- Experience in performing utilization review and/or providing clinical services in an intensive treatment setting
- Possession of a valid driver’s license and access to reliable transportation for job related use
- Excellent communication skills, both verbal and written
- Lived experiences with mental illness/developmental disabilities/substance use disorders valued
- Ability to work effectively in a multicultural environment and skills and capabilities of bridging language/cultural barriers to Network180 services within diverse communities preferred
We are committed to attracting a diverse and talented work force to meet the needs of our diverse community.
Network180 offers an attractive benefit package including health, dental, vision, retirement plan, life insurance, and short- and long-term disability.
For a detailed job description, responsibilities and information on how to apply directly through our website, please visit www.network180.org.
Applications accepted until the position is filled.
Network180 is an Equal Opportunity Employer. Network180 participates in E-Verify.