POSITION SUMMARY: Provides utilization management functions as a part of the Prepaid Inpatient Health Plan benefits management system. This includes providing utilization review and management for mental health and substance abuse services, as well as performing the identification, analysis and resolution of resource utilization outliers consistent with established protocols, policies and procedures. Serves as a liaison between agency programs. Works closely with finance and reimbursement departments for the purposes of care management, data analysis and practice, and system performance.

EDUCATION: Master’s or Doctorate Degree in Psychology, Social Work, or Counseling is required. P

EXPERIENCE/KNOWLEDGE: Two or more years’ experience providing treatment to individual’s mental illness or direct experience applying benefits and/ utilization management in a managed care setting. Excellent computer and interpersonal skills, punctuality, ability to organize and manage several projects/tasks simultaneously and work independently. Must maintain ethical standards, confidentiality and professional boundaries and support a trauma informed culture of safety to aid consumers in their recovery process. Preferred experience in a managed care environment.

LICENSURE/CERTIFICATIONS: Registered with the State of Michigan as a LMSW, LLP or LPC. Preferred candidates will possess a LMSW, BCBA and/or CAADC.