Northern Lakes Community Mental Health is looking for an Access Utilization Management Specialist in the Traverse City office. The primary duties of this clinical position involve the performance of Access, Authorization, Utilization Management and Customer Services. Activities include screening of non-emergent requests for service; initial clinical assessment of individual to determine appropriate level of care or provide referral assistance; initial orientation to CMH services; utilization review, level of care determination; authorization/reauthorization of services to consumers with mental illness or developmental disabilities; and customer service assistance/coordination. This position will include administration of the ADOS for purposes of evaluating children with concerns of autism spectrum disorder. Additional psychological resting may be necessary to administer if certified to do so.
This position requires experience with populations served, familiarity with the wide range of programs and services provided by or purchased by NLCMHA and an ability to match consumers to the appropriate scope and intensity of services required. This position will coordinate additional assignments to appropriate programs and will provide services in a welcoming manner, demonstrating co-occurring disorder competencies. This position is not responsible for the direct supervision of staff.
Essential Functions:
- Provide essential access system functions including welcoming, screening, eligibility determination, collection of relevant information for reporting and decision-making purposes, referrals, provision of relevant consumer information and provision of outreach services when necessary.
- Administration of specific tools to determine eligibility criteria for specific populations.
- Provide Customer Service, by answering questions regarding services offered, eligibility for service, benefit/insurance coverage information and/or information regarding possible complaints or concerns. Refer or assist individual to take actions to resolve questions or concerns.
- Obtain sufficient information from individuals requesting service to determine their apparent eligibility for service including demographics, clinical assessment and diagnosis, level of care determination and referrals.
- Provide face to face clinical assessments of potential new consumers.
- Provide new consumer initial orientation to CMH services including Person Centered Planning process.
- Working knowledge of external agencies and providers and ability to assist requestors of service in linking to other providers when there is a need. Follow up with individuals when appropriate and with consumer acceptance.
- Work efficiently with other person(s) in classification to ensure requests are responded to in a timely manner.
- Screen and address within access service any barriers to service, including speech, language and cultural needs or issues.
- Assure that customers with Limited English Proficiency or other special needs have available and receive appropriate assistance with respect to all CMHSP services, including access to and utilization of the PIHP grievance and appeal process.
- May participate in interventions, assessments, and other aspects of crisis services during and after hours as necessary.
- Is willing to travel to 4 office locations to assist in completing assessments for potential IDD consumers.
Qualifications:
- Master's Degree in Social Work or Clinical Psychology from an accredited university.
- Licensed as one of the following - must maintain licensure
- Licensed Masters Social Worker (LMSW)
- Limited Licensed Masters Social Worker (LLMSW)
- Masters Limited Psychologist
- Pyschologist
- Additional certification may be required for specialized services, such as CAC, Gerontology.
- Individual must be certified and experienced in administering the ADOS and ADI-R evaluations.
- Two (2) years' experience in the mental health field with experience in working with individuals with severe and persistent mental illness and individuals with Developmental Disabilities
- Demonstrated competency in the use of diagnostic skills to include the use of DSM IV
- Prior experience in performing utilization review functions is highly desirable
Pay: $69,284 - $79,284
Benefits:
- Medical Insurance (4 options)
- Dental Insurance (2 options)
- Vision Insurance (2 options)
- Health Savings Account
- Healthcare and dependent care flex spending account
- MERS Retirement Plan (with Employer matching up to 5%)
- Guaranteed step increase every year on your anniversary
- Paid Time Off (18 days in 1st year)
- Holidays (13 days)
- Sign On Bonus
- Referral Bonus (when you refer someone to join our team)
- Employee Assistance Program
- Short Term Disability
- Long Term Disability
- Accidental Death & Dismemberment Insurance
Questions or are you ready to apply? Email – human.resources@nlcmh.org with Access UM-Specialist (Traverse City) in the Subject Line.