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QMHP - Utilization Review and Management Specialist - $3,000 Signing Bonus!

Company: Central City Concern
Location: Gresham
Posted on: January 23, 2023

Job Description:

Since 1979, the Portland community has trusted Central City Concern (CCC) to help people create meaningful, long-term change. Every year, we serve more than 13,000 people experiencing or at risk of homelessness with affordable and supportive housing, person-centered health care, addiction recovery and employment assistance. By providing health care, housing and jobs, CCC is ending homelessness in Portland and helping people achieve their highest potential.

CCC is seeking a Utilization Review and Management Specialist (QMHP) to join our growing team!

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

The Utilization Review and Management Specialist is responsible for leading CCC's utilization review and management activities in Mental Behavioral Health Services. This role partners closely with Health Services leadership, the Office of Integration and Innovation, the Finance department, and other key functions to ensure client-centered, trauma-informed, and compliant level of care placement, transitions of care, and ongoing utilization review and management.

Duties to Include:

  • Design, implement, manage, and continuously improve a mental behavioral health utilization review and management program, including:
  • Perform routine admissions reviews to monitor appropriate initial placement of clients;
  • Identify opportunities for level of care placement reviews;
  • Complete level of care placement reviews;and
  • Collaborate with clinical care teams and clients to plan and execute level of care placement changes within CCC and to external providers.
  • Provide training and consultation to admissions specialists to ensure initial placement of clients at levels of care that adhere to medical necessity criteria, regulatory requirements, and insurance rules.
  • Provide training and consultation to clinical care teams to support adherence to medical necessity criteria, regulatory requirements, and insurance rules.
  • Collaborate with clinical care teams, leadership, and medical billing partners on issues related to level of care placement and transitions of care.
  • Partner with the Office of Integration and Innovation to design, implement, and continuously improve mental behavioral health care pathways.
  • Develop and maintain relationships with community partners, including providers and payers, related to mental behavioral health services access, level of care placement, and transitions of care.


    • Master's degree in a human services field and one year experience in mental health. Experience with severe and persistent mental illness (SPMI) preferred. Must meet State ISSR guidelines for QMHP.
    • Must meet CCC privileging requirements as required by FTCA.
    • Must have current CPR/BLS certification prior to start.
    • Strongly preferred: experience working with an under-served adult population experiencing mental illness, substance abuse, and/or houselessness.
    • Must possess a current driver's license, pass a DMV background check and be designated an "acceptable" driver as outlined in Central City Concern's Fleet Safety Policy. Must pass an initial drivers training within 60 days of being an approved driver and continued recertification training.
    • Must pass a pre-employment drug screen, TB test, and background check. This includes clearance by the DHS Background Check Unit.

      Central City Concern offers an incredible benefits package to our employees!
      • Generous paid time off plan beginning at 4 weeks per year at the time of hire. Accrual increases with longevity.
      • Amazing 403(b) Retirement Savings plan with an employer match of 4.25% in your 1 st year, 6% in the 2 nd year, and 8% in your 3 rd year!
      • 10 paid Holidays PLUS 2 Personal Holidays to be used at the employee's discretion.
      • Comprehensive Medical, Vision, and Dental insurance coverage.
      • Employer Paid Life, Short Term Disability, AND Long Term Disability Insurance!
      • Sabbatical Program offering extended time off at years 7, 14 and 21.
        Central City Concern is a second chance employer and complies with applicable laws regarding consideration of criminal background for employment purposes. Government regulations, contractual requirements, or the duties of this particular job may require CCC to conduct a background check and take appropriate action to address prior criminal convictions.

        Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

        The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Keywords: Central City Concern, Gresham , QMHP - Utilization Review and Management Specialist - $3,000 Signing Bonus!, Executive , Gresham, Oregon

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