Share Email Opening Title Utilization Management Clinician (LCSW or RN).  About the Organization Catholic Charities, Diocese of Trenton is a faith inspired non-profit organization, mission-driven, family-friendly, and passionate about services to our communities. We offer a wide variety of exciting career opportunities in the areas of Direct Care, Clinical, Fundraising, Human Resources, IT, Finance, Marketing, and Nursing. When you join us, you can expect a true focus on work-life balance, rewarding career, competitive salaries, and comprehensive benefit programs. Some of our benefits include: generous paid holidays, vacation, and sick time; Employee Assistance Program, excellent health & pension plans; Public Student Loan Forgiveness program; and wide array of training and staff development opportunities to earn on-site CEUs. Catholic Charities is an Affirmative Action / Equal Opportunity Employer, fostering a diverse and inclusive environment for staff as well as for people seeking assistance. To learn more about the agency, please visit our website at: www.catholiccharitiestrenton.org. For frequently asked questions, please click here: https://www.catholiccharitiestrenton.org/careers/frequently-asked-questions/   Req Number DIR-18-00143   Location CAS - Access Center (Lawrenceville, NJ)   Full-Time/Part-Time Full-Time   Number of Openings 1   Category Direct Care - Professionals / Paraprofessionals   Description JOB SUMMARY: Provides utilization management activities for all levels of behavioral health care including EISS, partial care, intensive outpatient and outpatient, PACT, Ambulatory Withdrawal management, and substance use. ESSENTIAL FUNCTIONS: Demonstrates clinical expertise in response to a variety of circumstances ranging from crisis intervention to routine business matters. Determines appropriate level of care related to mental health and substance use treatment for consumer based on program eligibility criteria. Utilizes best practice standards to render program eligibility criteria. Adheres to departmental and state guidelines and clinical best practice standards to facilitate a desired outcome. Consults with Catholic Charities Project Evaluator when request for services do not meet medical necessity criteria. Interacts with Clinical Staff and Therapists to discuss program placement, clinical questions, alternative treatment options, and concerns regarding specific cases. Completes appropriate documentation in clinical systems in compliance with regulatory and accreditation standards. Collaborates with clinicians to assess physical, behavioral, social, and transitional care needs and assists as needed to develop person centered, integrated, recovery oriented service plans to meet the needs of the consumer. Assists in the recommendation of client/consumers care to designated collaborating agencies and monitors care and length of stay. Assists in the compilation of program measurement/assessment data Monitors daily, weekly and monthly utilization reports to ensure that targets are met. Recognizes quality of care issues and reports them appropriately through internal/external processes under the direction of the Director of compliance. Makes recommendation of programs and/or systems that create improved outcomes and timeliness of the utilization management process. Participates in on-going continuing education as required. Participates in special committees or projects for program development as assigned. Adheres to policies and procedures for Utilization Management activities as well as screening, triage and referral activities, including timeliness of activities/services and accuracy of documentation. Documents all determinations, notifications, intervention and telephone encounters in the appropriate system and in accordance with established documentation standards and regulatory guidelines. Compiles statistical reports on a quarterly basis or as needed. KNOWLEDGE/SKILLS/ABILITIES: Experience and knowledge of: supported housing, supported employment programs, vocational rehabilitation, community integration programs, peer services, mobile crisis, PACT team, and other community services. Previous experience in Utilization management or Case Management Extensive clinical knowledge base Some travel may be involved. Strong knowledge about the impact of mental health, substance use disorders and psychosocial stressors on the physical health conditions. Excellent verbal and written communication skills and interpersonal skills are essential. Strong computer skills, including knowledge of EXCEL, MS Word, and POWERPOINT   Position Requirements MINIMUM QUALIFICATIONS: Master’s Degree in a related field from accredited university. Current, unrestricted license to practice independently as a Licensed Clinical Social Worker (LCSW) in the state of NJ preferred. RN with 5 years managed care experience acceptable. Minimum of five (5) year post-licensure experience in direct clinical care with high risk/complex consumers in facility based and/or outpatient psychiatric or substance use treatment facilities. Experience with an Electronic Medical Record Strong computer and analytical skills – Excel, Dashboards, etc. ~cb   Exempt/Non-Exempt Exempt   Weekly Work Hours 40   Proposed Salary $50,000/ year   Schedule 8am-4pm or 9am-5pm  This position is currently not accepting applications. 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