Job description
Pay Plan Title:Utilization Management Specialist II
Working Title:Utilization Management Specialist II
Position Number:04004
FLSA Status:Exempt
Posting Salary Range:$56,270 - $69,898
Office Location:Remote within North Carolina.
POSTING DETAILS:
Make an Impact
Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.
Why Work for Us?
Trillium believes that empowering others begins with supporting our team. We offer our employees:
A collaborative, mission-driven work environment
Competitive benefits and work-from-home options for most positions
Opportunities for professional growth in a diverse inclusive culture
Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.
If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!
What We’re Looking For
Trillium Health Resources has a career opening for a Utilization Management Specialist II to join our team! The Utilization Management Specialist II supports clinical review by validating service authorization requests and managing workflow from intake through determination. The role reviews requests for completeness, routes cases to appropriate clinical staff, and monitors authorization timelines to ensure timely, accurate clinical review and decision-making.
On a typical day, you might:
Validate service authorization requests against benefit requirements and submission standards prior to clinical review or for post payment reviews.
Identify missing or inconsistent documentation and obtain required information from providers.
Route complete requests to appropriate clinical reviewers based on service type and urgency.
Monitor authorization timeframes and follow up to prevent delays in clinical review.
Track determinations and ensure authorization status is accurately reflected in systems.
Employee Benefits:
Trillium knows that work/life balance is essential. That’s why we offer:
Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval.
Work-from-home options available for most positions
Health Insurance with no premium for employee coverage
Flexible Spending Accounts
24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
NC Local Government Retirement Pension (defined-benefit plan)
401k with 5% employer match and immediate vesting
Public Service Loan Forgiveness (PSLF) qualifying employer
Quarterly stipend for remote work supplies
Qualifications
Required:
High School Diploma/GED and six (6) years’ experience working in the MH/SU/IDD field; OR
Associate’s degree and four (4) years’ experience working in the MH/SU/IDD field;OR
Bachelor’sdegree and two (2) years’ experience working in the MH/SU/IDD field; OR
Equivalent combination of education/experience.
Must have a valid driver’s license.
Must reside within North Carolina.
Must be able to travel within catchment as required.
Preferred:
Experience working with the PH/BH/MH/SU/IDD population.
Familiarity with and understanding of medical terminology.
Deadline for Application:Friday, October 2, 2026 @ 11:59PM
How to Apply
To be considered, submit your application and resume through our ADP Career Center. Your resume must include:
Employer name, dates of service (month/year), average hours worked per week, and essential job duties
Education details (degree type, date awarded, institution, field of study)
Licensure/certification information, if applicable
After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You’ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.
Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.
Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.
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Originally posted on Himalayas
Who can apply
Eligible countries: United States. Accepted UTC offsets: UTC-10, UTC-9, UTC-8, UTC-7, UTC-6, UTC-5, UTC+14. Review the full description for employer-specific work authorization, residency and schedule requirements.