Utilization Review Specialist

Network180 - Kent County Community Mental Health

. Perform utilization review of intellectual and developmental disability services, mental health, and substance use disorder intensive treatment services .

Posted 10/22/2026full-timeRemote • Michigan • United StatesMid-LevelSenior💰 $63,103 - $83,648 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in utilization review and assessment of treatment plans for intellectual and developmental disabilities, mental health, and substance use disorders. Proficient in navigating multicultural environments and applying clinical knowledge to ensure effective service delivery.

Highest-signal resume keywords

Licensed Master Of Social Work (LMSW)Licensed Marriage And Family Therapist (LMFT)Licensed Professional Counselor (LPC)Registered Nurse (RN)QIDP Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ReviewClinical AssessmentTreatment PlanningMedical Necessity Criteria InterpretationPsychological AssessmentData EntryDatabase ManagementProject ManagementCrisis Communication

Soft Skills

Excellent Communication SkillsMulticultural CompetenceStress ManagementTeam Collaboration

Tools & Technologies

Word Processing SoftwareSpreadsheet SoftwareEmail Applications

Certifications & Qualifications

Licensed Master Of Social Work (LMSW)Licensed Marriage And Family Therapist (LMFT)Licensed Professional Counselor (LPC)Limited Licensed Psychologist (LLP)QIDP CertificationCMHP Certification

Industry Keywords

Behavioral Health ServicesIntellectual And Developmental DisabilitiesMental HealthSubstance Use DisorderCultural BarriersClinical ExperienceProfessional EthicsStandards Of Practice

About the role

Key responsibilities & impact

Perform utilization review of intellectual and developmental disability services, mental health, and substance use disorder intensive treatment services
Assess individuals’ current or proposed treatment plans
Identify and address potential barriers to discharge
Assist in transitioning care to an appropriate intensity service setting
Work full-time Monday through Friday, 8:00am to 4:30pm
Potentially work an occasional weekend day or holiday depending on utilization-review volume
Travel occasionally within the Kent County community and surrounding areas
Communicate and bridge language/cultural barriers to Network180 services within diverse communities
Participate in interviews conducted in person or via the internet

Requirements

What you’ll need

Fully licensed Master of Social Work (LMSW), fully licensed Marriage and Family Therapist (LMFT), fully licensed Professional Counselor (LPC); or limited licensed Psychologist (LLP), with at least five (5) years of clinical experience (at least two [2] years of clinical experience post-licensure preferred)
Or Registered Nurse (RN) in Michigan with at least two (2) years of clinical experience in the delivery of behavioral health services
Ability to interpret clinical summaries and apply established medical necessity criteria to make utilization decisions
Thorough working knowledge of the practices and principles of psychological, emotional, and sociological assessment and diagnosis
Thorough working knowledge of professional ethics and standards of practice
Ability to handle multiple projects simultaneously
Computer skills including word processing, spreadsheets, email, database management, and data entry skills
Ability to work in a fast-paced environment
Ability to communicate clearly and concisely in stressful situations
Excellent communication skills, both verbal and written
Ability to work effectively in a multicultural environment and bridge language/cultural barriers to Network180 services within diverse communities
Successful completion of a drug screen as part of the background check process
Must comply with Network180's drug and alcohol-free workplace policy, including prohibition of recreational marijuana use
QIDP preferred for positions reviewing intellectual and developmental disability services; requires one-year full-time experience working with persons with developmental disabilities and appropriate license/degree per State of Michigan
CMHP preferred for positions reviewing children's services; requires one year of experience in examination, evaluation, and treatment of minors and their families and appropriate license/degree per State of Michigan

Benefits

Comp & perks

Four health insurance plans
100% employer paid dental and vision insurance plans
13 paid holidays
Generous PTO
Professional development
Tuition reimbursement
Professional License reimbursement
Defined contribution retirement plan
Employee Assistance program
Life and voluntary life insurance options
Short and Long term disability
Approved site for loan forgiveness (based on position and department): NHSC, STAR Loan Repayment, Behavioral Health Loan Repayment, MI Kids Now Loan Repayment and much more!
No weekends, on-call or holiday requirements for this position
Remote work arrangement
Equal opportunity employment
Reasonable accommodations for individuals with disabilities