At A Beautiful Mind, Inc., our employees are driven by a deep sense of service, high standards of professionalism and a responsibility to better the public good. We are currently seeking an Utilization Reviewer/Trainer who has a passion for providing the highest quality care in an institutional, secure setting. Come join a team that is dedicated to making an impact for the people and communities we serve.

Job Summary:
The Utilization Reviewer/Trainer will monitor adherence to the community health center’s utilization review plan to ensure the effective and efficient use of behavioral health and substance disorder use services and monitor, as well as train on the appropriateness of the center’s admissions and treatment/service plans.

• Perform utilization review of the organization’s treatment services to clients.
• Perform utilization review of clients’ SOAP notes.
• Assess individuals’ current or proposed treatment plan to identify and address potential barriers to discharge and assist in transitioning care to a lower intensity service setting.
• Monitor the quality of care, and the member’s response to services and products delivered to determine if the goals of the plan of care are being achieved, whether those goals remain appropriate and realistic, and what actions may be implemented to enhance positive outcomes and promote optimal health.
• Assess and identify appropriate resource utilization, level of care and treatment options to develop a plan of care that will impact quality outcomes in a cost-effective manner.
• Actively promote frequent communication between team members to enable a smooth transition from one level of care to another to ensure quality care is provided.
• Effectively cultivate and maintain working relationships with all providers of care including management by maintaining regular communications and professional rapport.
• Ensures the accurate data entry of all clinical information and authorizations.
• Demonstrates an ability to effectively communicate utilization decisions to healthcare professionals and ensure the development of collaborative treatment plans.
• Identify methods to add value to treatment plans and client assessments throughout the entire treatment plan.
• Train clinicians on compliance with organizational client treatment and assessment policies and procedures, including code of conduct and attendance policy; and policies resulting from the HIPAA privacy rules regarding individually identifiable health information concerning individuals served by A Beautiful Mind Inc.

Required Qualifications:

• Licensed Psychologist, LSW, LCSW, LPC or LCPC.
• Any license must be active and unrestricted in the state of Illinois
• 2 years plus of experience providing direct clinical care in a behavioral health treatment setting with emphasis on assessment, case management, and/or crisis intervention
• Proficient in Microsoft Excel, Word, PowerPoint, and Outlook

Preferred Qualifications:

• Dual diagnosis experience with mental health and substance abuse
• Experience working in an environment that requires coordination of benefits and utilization of multiple groups and resources for client