Clinical Utilization Manager


Social Care

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Branch Information

Taylor, MI - (USA) 10115 Telegraph MI Taylor , MI - 48180 Phone : 313-291-2089



Job Description

Responsible for authorizing services for Department of Human Services neglect and abuse cases in which a Jurist (Judge or Referee) of the Third Judicial Court or DHS/CPN worker requests and interventions to assist the caretakers or family members to resolve issue that put the child(ren) at risk from removal form the home. Services are authorized through the JAC Therapeutic Services specialized, Provider Network Agencies (PNAs); technical assistance is provided to the PNAs through meetings and training's. Duties also include authorizing, monitoring and managing service request(s) to assure that services are conducted in a timely manner with appropriately documented clinical service interventions which could result in effective and satisfactory outcomes, allowing the children to be reunited with their family.
Department Specific Objectives:
-Effectively demonstrate working knowledge of the Child Welfare System
-Punctuality in regards to tardiness and absences
-View and analyze problems objectively and resolve them in a timely manner
-Attention to detail to assure accuracy and meet timelines
-monitors and evaluates activities and services of PNAs
-Reviews services from PNAs and enters status in JAIS by the 15th and 30th of every month
-Completes unit requests to assure PNAs utilization review of required documents
-Reviews Billable Status reports
Familiar with case log-in and authorization process
-Familiar with psychological/psychiatric authorization and completion process
-Handles case files promptly and efficiently
-Ensure loose paperwork is placed in the "to be filed" tray
-Screens phone calls
-Conducts training's and meetings for providers
-Developing audit time frames, goals and objectives
-Completes all tasks and duties assigned by the Senior Lead, TS Supervisor or other Executive Staff members.
Bachelors level clinical (Social work, Counseling, Psychology). 3-5 years of experience working in the social service field. Extensive experience in service coordination and understanding treatments for clients with clinical issues of substance abuse, adult and child mental health and family services coordination requires. Ability to work rapidly with a high degree of precision and to ensure accuracy and meet prescribed deadlines. Thorough understanding of clinical utilization management and billing with actually experience preferred.
Pay rate is commensurate with experience, $18-$20 per hour.