Utilization Management Specialist III – MH/SU

Trillium Health Resources

. Provide comprehensive clinical review of service requests for people experiencing psychiatric symptoms related to mental health issues, substance use, developmental disabilities, or co-occurring conditions .

Posted 10/13/2026full-timeRemote • North Carolina • United StatesJunior💰 $68,890 - $92,138 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical review and utilization management for individuals with psychiatric symptoms, ensuring compliance with Client Rights Rules and evidence-based practices. Proficient in making service authorization decisions and providing consultation to providers within the behavioral health, mental health, substance use, and developmental disabilities domains.

Highest-signal resume keywords

Clinical ReviewUtilization ManagementLicensed Clinical Social Worker (LCSW)Behavioral Health ExperienceDocumentation Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical TriageService AuthorizationTreatment Documentation ReviewEvidence-Based PracticesMedical Necessity Criteria

Soft Skills

ConsultationTechnical AssistanceClear Communication

Certifications & Qualifications

Licensed Clinical Mental Health Counselor (LCMHC)Licensed Marriage and Family Therapist (LMFT)Licensed Psychological Associate (LPA)Licensed Clinical Addictions Specialist (LCAS)Registered Nurse (RN)

Industry Keywords

Mental HealthSubstance UseDevelopmental DisabilitiesCo-Occurring ConditionsClient Rights Rules

About the role

Key responsibilities & impact

Provide comprehensive clinical review of service requests for people experiencing psychiatric symptoms related to mental health issues, substance use, developmental disabilities, or co-occurring conditions
Review diagnoses, medical necessity criteria, member eligibility, and level of care needs
Make service authorization decisions 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, evidence-based practices, and scope-of-practice issues
Conduct ongoing review, staffing, and consultation of treatment documentation for members participating in group, family, or individual services

Requirements

What you’ll need

Master's degree in health and human services or related field
One (1) year of experience providing 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), or 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
All candidates must pass a drug test as a condition of employment
Resume must include employer name, dates of service, average hours worked per week, essential job duties, education details, and licensure/certification information if applicable

Benefits

Comp & perks

A collaborative, mission-driven work environment
Competitive benefits
Work-from-home options for most positions
Opportunities for professional growth in a diverse inclusive culture
Flexible work schedules with some roles with management approval
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)
401k with 5% employer match and immediate vesting
Public Service Loan Forgiveness (PSLF) qualifying employer
Quarterly stipend for remote work supplies