Utilization Management Specialist III - MH/SU

Pay Plan Title: Utilization Management Specialist III Working Title: Utilization Management Specialist III MH/SUFLSA Status: Exempt Posting Salary Range: $68,890- $92,138 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives. Why Work for Us Trillium believes that empowering others begins with supporting our team. A collaborative, mission-driven work environment Competitive benefits and work-from-home options for most positions Opportunities for professional growth in a diverse inclusive culture Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities. What We’re Looking For Trillium Health Resources has a career opening for a Utilization Management Specialist III - MH/SU to join our team! The Utilization Management Specialist III - MH/SU is responsible for providing comprehensive clinical review of services requests for people who experience psychiatric symptoms related to mental health issues and/or co-occurring or co-morbid conditions or symptoms or addictions to substances and/or developmental disabilities. On a typical day, you might: Provide clinical review of services for members or enrollees with mental health, substance use, and/or developmental disabilities including diagnosis review, medical necessity criteria, determining member eligibility; level of care needed and making service authorization decisions regarding individual service authorizations with timely, clear, concise documentation. Provide clinical triage for members seeking services through Screening, Triage and Referral. Provide consultation and technical assistance to providers regarding clinical care needs, levels of care, Client Rights Rules, evidenced based practices, scope of practice issues etc. Provide ongoing review/staffing/consultation of treatment documentation of needs for members participating in group, family or individual services. Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval. Employee Benefits Trillium knows that work/life balance is essential. That’s why we offer: Work-from-home options available for most positions. Health Insurance with no premium for employee coverage Flexible Spending Accounts 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year NC Local Government Retirement Pension (defined-benefit plan) systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook 401k with 5% employer match and immediate vesting Public Service Loan Forgiveness (PSLF) qualifying employer Quarterly stipend for remote work supplies Qualifications Master's degree in health and human services or related field and one (1) year of experienceproviding Utilization Management services. Active North Carolina licensure as: Licensed Clinical Social Worker (LCSW) Licensed Clinical Mental Health Counselor (LCMHC) Licensed Marriage and Family Therapist (LMFT) Licensed Psychological Associate (LPA) Licensed Clinical Addictions Specialist (LCAS) Registered Nurse (RN) Must have a valid driver’s license. Must reside within North Carolina. Must be able to travel within catchment as required. Preferred: A minimum of two (2) years of post-Master’s experience in a clinical setting with the BH/MH/SU/IDD population. Deadline for Application: Wednesday, October 21, 2026 at 11:59pm Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.

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