Behavioral Health Utilization Management Specialist
Description
Exciting Career Opportunity!
The Behavioral Health Utilization Management (UM) Specialist is responsible for reviewing and evaluating mental health and substance use treatment services to ensure they are medically necessary, cost-effective, and aligned with clinical guidelines. This role supports quality care delivery while managing behavioral health resources efficiently. To view full job description details, click here: UM Specialist - GMCS
Schedule
Tuesday through Saturday.
Shift
2:00 pm – 10:00 pm OR 3:00 pm – 11:00 pm
Hybrid Expectations
* Internet speed test to ensure the individual selected meets internet speed requirements. *
You are expected to maintain strong private internet access to ensure access to electronic health records, internal team communication, and otherwise.
Most of the work for this position will be conducted remotely. In-person requirements for the position include attending at least one on-site staff meeting each month and at least one day of typical work each month to assist in building rapport with the team, for a minimum of two shifts per month on-site.
Compensation
$29.00 - $34.00 per hour, plus applicable shift differential.
Key Responsibilities
- Conduct utilization reviews for behavioral health services including inpatient, outpatient, intensive outpatient, and residential treatment.
- Apply evidence-based criteria (e.g., ASAM, LOCUS, MCG, InterQual) to assess medical necessity and level of care.
- Collaborate with providers, case managers, and care teams to coordinate appropriate treatment plans.
- Review prior authorization requests and make determinations or escalate to clinical leadership as needed.
- Monitor ongoing treatment for continued appropriateness and effectiveness.
- Document all UM activities in compliance with regulatory, accreditation, and organizational standards.
- Identify trends in service utilization and contribute to quality improvement initiatives.
- Stay current with behavioral health regulations, parity laws, and best practices.
Qualifications
Education
- Master’s degree in Social Work, Psychology, Counseling, or related field.
Licensure
- Active, unrestricted Michigan clinical license (e.g., LLMSW, LCSW/LMSW, LLPC, LPC, MLP) required.
Experience
- 2+ years in behavioral health clinical practice and/or utilization management.
- Minimum of 3 years in diagnosing, treating people with mental health, substance use disorders, and developmental disabilities.
- Experience working in crisis intervention or emergency mental health services
- Strong background in substance use disorder treatment
- Experience with persons with co-occurring mental illness and substance use disorder
Certifications
- Meets criteria as a Qualified Mental Health Professional (QMHP) defined by the State of Michigan
- Meets criteria as a Child Mental Health Professional (CMHP) OR Qualified Intellectual Disabilities Professional (QIDP) defined by the State of Michigan
- Certified Utilization Review Professional (URAC), CCM, or similar preferred. Active Michigan Certification Board of Addiction Professionals (MCBAP) credential (i.e., CADC, CAADC, CCS) strongly preferred
Skills
- Strong understanding of behavioral health diagnoses, treatment modalities, and care levels.
- Familiarity with DSM-5, ICD-10, and behavioral health coding.
- Excellent communication, documentation, and critical thinking skills.
- Proficiency in UM platforms and electronic health records (EHRs).
What Makes Us Different?
- Non-Profit mission-driven, person-focused environment
- Be part of a purpose-driven team serving individuals in crisis 24/7
- Work in an organization that values healing, recovery, and human connection
- Help shape and grow a vital program meeting urgent community
- Opportunity for professional growth
- Team orientated environment
- An organizational culture of mental & behavioral health support for all
For your hard work
- Employer sponsored benefit & wellness plans (including 16% fringe pay, etc.)
- Free Premium subscription to the CALM app – because your wellness matters too
- Competitive pay
- Generous Paid Time Off to recharge and refocus
Common Ground is one of the top-ten crisis intervention organizations in the country. For over 50 years we have been helping people move from crisis to hope. At Common Ground, we help individuals and families who are experiencing crises of any kind, from suicide to substance use, human trafficking, mental illness and more.
Helping people in crisis 24/7 is at the heart of everything we do by offering hope, healing and recovery. Our caring and dedicated team meets people wherever they are; in person, call, text, chat, or virtually. We listen, assist, and advocate for anyone needing emotional support so they do not feel alone.
Common Ground is an Equal Opportunity/Affirmative Action Employer. We consider all qualified applicants without regard to race, religion, color, sex, gender, national origin, age, sexual orientation, disability or veteran status, among other factors.
Find out more at https://commongroundhelps.org
Apply now and help bring hope where it's needed most.