StarCare Specialty Health System (StarCare) is seeking a full time Utilization Management (UM) Reviewer to join its outstanding Utilization Management team supporting the agency's various mental health authorization processes.

Responsibilities:

• Provide Utilization Management functions in Mental Health Services.
• Authorization of services based upon UM Guidelines.
• Coordination and management of the Discharge Process.
• Management of capacity related to Mental Health Service authorizations, and the management of the Mental Health Waiting Lists and Pre-Authorization Lists.
• Conduct additional specific UM Reviews as needed.
• Assist with the administrative functions of the UM Department.
• Participate in the MAC Time Study as required and utilize Medicaid decision-making authority.
• Complete all required documentation.
• Communicate information to supervisor and other agency employees or vendors.
• Assist with special projects or assignments as needed or as requested.

Schedule: This is a full-time/non-exempt position scheduled Monday – Friday, 8am – 5pm, with flexibility to meet the needs of the department. The position is based in Lubbock and will work in a hybrid work environment (combination of remote and on-site) and must be able to work on-site when job duties require or when requested by supervisor.

Benefit Package: StarCare offers an expansive benefit package including, but not limited to: Company-paid medical coverage, fully funded employer contribution to HSA, company-paid life insurance, company paid hospital indemnity plan, retirement plan with up to 12% employer match, front loaded paid time off (PTO), thirteen (13) paid holidays, sabbatical leave, longevity augmentations, and employee referral augmentations.

Qualifications:

• Graduation from accredited four (4) year college or university with major course work in a Human Services Field (Psychology, Sociology, Family Studies, etc.)
• Must have at least three (3) years of clinically appropriate experience in direct care for adults and/or children with serious mental illness or emotional disturbance and/or chemical dependency.

Skills & Abilities:

• Knowledge and skill in operating standard office equipment and personal computer with Microsoft Office products is required.
• Ability to communicate effectively, both orally, and in writing.
• Ability to maintain an effective working relationship with other employees and the public.
• Ability to organize and prioritize a variety of assignments and manage time effectively.
• Ability to problem-solve and make decisions based upon specific criteria.
• Knowledge of current healthcare standards.
• Knowledge of appropriate rules, regulations, and policies and procedures.
• Knowledge of general DSM-5 language and concepts.
• Knowledge of the Mental Health Service Delivery system.

Additional Requirements:

• Must pass a pre-hire drug screen and criminal background check.
• Must have a Texas driver's license, liability auto insurance, and be insurable under the Agency's insurance.