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SOUND Behavioral Health is growing and welcoming a utilization management specialist to our Keystone residential facility in Seattle, WA!

 Sound is one of King County’s most comprehensive providers of quality mental health and addiction treatment services, supporting our area’s most vulnerable populations. A central tenet of our work is Reaching Recovery, an evidence-based clinical care model.

Sound clinicians are focused on demonstrating compassion, patience, and understanding when treating clients. We believe in and advocate for Diversity, Equity, Justice, and Inclusion for our team and clients. 

This position will manage the utilization compliance of services and the success of outcome measures for Sound's Residential Treatment Facilities.

Schedule: Monday - Friday 8:00am-5:00pm.

Location: On-site at Keystone residential facility in the Fremont neighborhood.

• Conduct utilization reviews for mental health residential treatment facilities across all payors, including Managed Care Organizations (MCOs).
• Manage utilization processes, including pre-authorization, initial reviews, and concurrent reviews in accordance with King County Utilization Management requirements and timeframes.
• Document utilization management review outcomes in client records.
• Facilitate effective communication among team members, providers, payors, individuals, and their families to ensure smooth transitions across levels of care.
• Build and maintain professional relationships with community providers, managed care organizations, and internal team members through regular communication.
• Perform accurate data entry of authorizations and ensure documentation aligns with regulatory requirements.
• Assist in handling appeals related to denied services with managed care organizations as needed.
• Conduct monthly chart reviews to verify signed and attached Releases for Information.
• Maintain composure and professionalism in high-stress situations, identifying and addressing potential high-risk scenarios through utilization review.
• Participate in assigned projects using the project management framework.
• Perform additional duties as assigned by the senior supervisor.

The Utilization Management Specialist fosters positive, ethical, and professional working relationships with clinical team members, clients, payors, and external organizations. This role requires cultural competency and the ability to work effectively with individuals from diverse backgrounds, including ethnic and sexual minority populations.

EDUCATION AND EXPERIENCE

• Master’s degree in social work, psychology, or a counseling – related field (MSW, MS, MA) is required
• Preferred: Prior experience in utilization review processes, including evaluating the necessity, appropriateness, and efficiency of healthcare services.

KNOWLEDGE, ABILITIES, AND SKILLS

• Ability to document and communicate medical necessity for residential levels of care to payors.
• Strong understanding of mental and behavioral health services in King County, including state and local healthcare systems, funding principles, and clinical service mandates.
• Familiarity with recovery-oriented behavioral health concepts and ability to apply them in practice.
• Strong organizational skills, with the ability to quickly learn new tasks, manage multiple responsibilities, and respond effectively to crises.
• Capacity to work collaboratively with a diverse and complex population while maintaining professionalism and sensitivity.

CERTIFICATES, LICENSES & REGISTRATIONS

• Must obtain a Home Care Aide (HCA) or Certified Nursing Assistant (CNA) credential within five months of hire.
• Washington State licensure as an LMHC, LICSW, LMFT, or associate-level therapist is highly preferred.
• If not licensed, must obtain Washington State Certified or Licensed Agency Affiliated Counselor (CAAC or LAAC) status within 60 days of hire.
• Must meet Mental Health Professional (MHP) designation requirements.
• Valid Washington State driver’s license with an insurable driving record is required.
• Must pass a criminal background check.

PHYSICAL DEMANDS

To successfully perform the essential duties of this Job, an individual must be able to sit at a desk for four or more hours a day and use office equipment, including phones and computer keyboards, for four or more hours per day. Individuals must be able to engage vendors, team members, clients, and others over the phone and in person by voice. Regular attendance is an essential function of the Job. Reasonable accommodations may be made to assist individuals with disabilities to perform essential Job functions.

LIMITATIONS AND DISCLAIMER

The above Job description is meant to describe the general nature and level of work performed; it is not intended as an exhaustive list of all duties, responsibilities, and required skills for the Job. Team members will be required to follow any other Job-related instructions and to perform other duties requested by their supervisor in compliance with Federal and State laws. Requirements are representative of minimum levels of knowledge, skills and/or abilities necessary to perform each duty proficiently. Continued employment remains on an “at-will” basis.

All Team Members at Sound working 40 hours per week will be eligible for the following benefits:

• 100% Paid Medical & Dental Insurance
  • Full time Team Member and child(ren) coverage until child's 26th birthday
  • Spouse/Domestic Partner coverage available (team member pays full cost)
• Paid Life Insurance
  
  • 2x annual salary + additional $25,000
• Long Term Disability Insurance (60% monthly salary)
  
  • 100% premiums paid by Sound
• 18 Days of Paid Rest and Relaxation (Vacation) - beginning first year
• 12 Days of Paid Sick Leave
• 9 Days of Paid Holidays
• Health Savings Account (HSA)
• Flexible Spending Accounts (FSA)
  
  • for health care (limited) and dependent day care costs (pre-tax)
• Employee Assistance Plan (EAP)
  
  • The Standard
• Sound retirement plan:
  
  • 401(k) plan (organization contribution) – Sound contributes 3% to team members' plan, even if you don’t.  
  • Team members are 100% vested; team members may contribute to their own plan
• Paid Training
  
  • Free in-house professional training and $400 annually + 3 paid days off-site training
• Public Service Loan Forgiveness (PSLF)
• Free Supervision Hours -  Washington State Licensure
• Service Award - at 5,10,15,20 & 25 years of service

Compensation: $30.31-$35.66 per hour.