Utilization Manager Clinician

ATHENA Consulting is an award-winning staffing firm serving state and local governments with a mission to make lives better by supporting clients and cultivating employee talents.

About the role

This full-time, remote position is based out of Hanover, MD and requires a Maryland license. The Utilization Manager Clinician manages psychiatric and substance abuse disorder treatment health benefits through telephonic or written review.

Responsibilities

• Use screening criteria and clinical judgment to assess member needs, ensuring access to medically necessary, cost-effective behavioral healthcare in accordance with UM Clinical Guidelines and contract.
• Refer cases to Peer Reviewers as appropriate.
• Perform psychiatric and substance abuse disorder assessment, coordination, implementation, case planning, monitoring, and evaluation to promote quality member outcomes and optimize health benefits.
• Serve as a resource to other Behavioral Health Care Managers.
• Assist with complex cases and participate in inter- and intradepartmental teams, projects, and initiatives.
• Participate in developing department goals, objectives, and systems.
• Attend staff meetings, other meetings, and seminars as assigned.
• Recommend new approaches, policies, and procedures to improve department efficiency and services.
• Perform duties efficiently and work collaboratively within the division and company.
• Complete other related duties as assigned.

Requirements

• MA/MS in social work, counseling, or a related behavioral health field, or a degree in nursing, with a minimum of 3 years of experience in facility-based and/or outpatient psychiatric and substance abuse disorder treatment; or equivalent combination of education and experience.
• Current, active, unrestricted license (e.g., RN, LCSW, LPC, LMSW, LGPC, LMFT, or Clinical Psychologist) to practice within the scope of licensure in Maryland.

Skills

• Excellent verbal, written, and listening communication skills in English.
• Proven high-quality customer service for internal and external customers.
• Ability to work collaboratively and analyze situations to adopt appropriate courses of action.
• Strong organizational skills and attention to detail.
• Ability to prioritize tasks and communicate effectively to large and small audiences.
• Proficiency with Microsoft Office Suite or related software.

Physical Requirements

• Possible prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift and move up to 25 pounds at times.

Pay

$34.00–$37.50 per hour, depending on experience.

Schedule

Standard hours: Monday through Friday, 8:00 am – 5:00 pm.

Benefits

• 19 days of PTO.
• 12 paid holidays (13 during election years).
• Merit/COLA increases.
• Flex time allowed during the same week.
• Medical, dental, and vision insurance.
• Medical and dependent flexible spending account.
• Pet insurance.
• Mass transportation benefit for the Maryland and Washington, D.C. area.
• 401k with a generous employer match.
• Employee self-serve HR portal.