Utilization Management (UM) Coordinator – (IDD)

**Pay Plan Title:** Coordinator **Working Title: Utilization Management (UM) Coordinator** **– (IDD)** **FLSA Status:** Exempt **Posting Salary Range:** $56,270 - $69,898 **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. We offer our employees: - 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. If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today! **What We’re Looking For** Trillium Health Resources has a career opening for a Utilization Management (UM) Coordinator to join our team! The UM Coordinator is responsible for managing the administrative components of the clinical review process for service authorization requests primarily related to Innovations Waiver services for Intellectual/Developmental Disabilities (IDD), as well as Behavioral Health (BH)/Mental Health (MH), and Substance Use (SU) services. This position is responsible for pre-screening requests to determine completeness and compliance with the Trillium Benefit Plan and Clinical Coverage Policies, ensuring they are ready for clinical review. Working collaboratively with Utilization Management (UM) Clinicians, this position oversees documentation accuracy, tracks review timelines and outcomes, communicates decisions to providers, and ensures required notifications are issued appropriately. **On a typical day, you might:** - Review and pre-screen IDD/MHSU service authorization requests. - Manage and monitor the timeliness of clinical reviews. - Coordinate and oversee the submission of clinical documentation. - Track Peer Reviewer decisions and independently communicate outcomes to clinicians. - Ensure all required notices and actions are issued appropriately and on time. **Employee Benefits:** Trillium knows that work/life balance is essential. That’s why we offer: - Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval. - 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) https://www.myncretirement.gov/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** Required: - High School Diploma/GED and six (6) years’ experience working in the BH/MH/SU/IDD field; **OR** - Associate’s degree in Human Services, Health, or related field and four (4) years’ experience working in the BH/MH/SU/IDD field; **OR** - Bachelor’s degree in Human Services, Health, or related field and two (2) years’ experience working in the BH/MH/SU/IDD field; **OR** - Equivalent combination of education/experience. - Must have a valid driver’s license. - Must reside within North Carolina. - Must be able to travel within catchment as required. Preferred: - Experience working with the IDD/BH/MH/SU/ populati…