At Jefferson Center, it is our policy and our mission to be inclusive and mindful of the diversity of everyone who comes through our doors. We are passionate about building a community where mental health matters and equitable care is accessible to all races, ethnicities, abilities, socioeconomic statuses, ages, sexual orientations, gender expressions, religions, cultures, and languages.

The overall responsibility of the Utilization Review (UR)/Utilization Management (UM) Coordinator & Admissions position is to develop and maintain a uniform set of consistently applied policies and practices to support, monitor, and report on utilization management throughout Jefferson Center Adult Residential Recovery program. This is to be accomplished by working with clinical, medical, administrative, managed care, management and executive leadership in the formulation, documentation and implementation of UM standards and through communication with management teams and training staff. The UR/UM & Admissions Coordinator will have knowledge of the American Society of Addiction Medicine (ASAM) Criteria, including its Dimensions and Severity Ratings. UR/UM & Admissions Coordinator is the primary representative and trouble-shooter internally and externally with Front Range Behavioral Health and the Regional Accountability Entity's (RAEs) and other external payers related to UM for SUD Services.

Essential Duties:

• Train and troubleshoot with managers and clinicians on utilization management procedures
• Complete, Coordinate and track Health First Colorado (Medicaid) pre-authorizations, Concurrent Reviews and Discharge summaries for payment.
• Perform, as assigned, and ensure that all elements and functions of the Utilization Management activities are met and performed in a timely manner.
• Monitor, review, report, and investigate practice patterns, utilization trends and billing issues and report to management and financial teams of any concerns.
• Participate in utilization reviews with clinical teams and RAE's
• Effectively and professionally communicates findings, outcomes, and decisions to appropriate parties
• Work with other departments throughout Jefferson Center, clinical managers, and other appropriate persons to assist with the design, documentation, training, and implementation and monitoring of utilization management processes and/or systems to ensure consistent, uniform compliance with all contractual requirements and other professional standards.
• Other Duties: Other duties and project management as assigned.

Other Duties (Productivity Performance Measures, Professional Growth/Development, Relationships/Communication):

• Participates on various interagency committees as requested by Manager
• Participates in supervision by coming prepared with an agenda. Reports high risk/problem cases using a problem-solving approach as well as feedback
• Attends mandatory in-services, staff meetings, clinical supervision, and on-line training as required.
• Sharing knowledge and skill with completion of biopsychosocial assessments and utilizing the ASAM Criteria, including dimensions and severity ratings to appropriately identify level of care for patients for the Medicaid pre-authorization, continuation of care and step down process
• Participates in staff development activities that enhance professional growth.
• Have an understanding of how trauma impacts the lives of the people being served, so that every interaction is consistent with the recovery process and reduces the possibility of retraumatization.
• Ensure that delivery practices are guided by the principles of trauma informed care and the principles of addiction treatment.
• Maintains effective interpersonal relations with consumers, peers, subordinates, upper management, visitors and the general public. Uses language and behavior to promote dignity and respect.
• Corporate Compliance including documentation on practice in accordance with regulatory requirements and clinical guidelines.
• Exhibits enthusiasm, respect, adaptability, flexibility, and spirit of cooperation in the work environment.
• Attends the quarterly CAS/LAC business meetings in order to stay abreast of regulations and policies governing substance abuse treatment and Medicaid requirements.
• Participate in CAS/LAC group supervision per OBH regulations. CAS (CAC II), 2 hours each month, CAS (CAC III) or LAC one hour each month.
• Provide CAS/LAC in training group or individual supervision to staff obtaining their certification (CAS/CAC III or LAC only) and/or assist with supervising or mentoring new license eligible clinicians.
• Other job duties as assigned, including but not limited to supporting on other related teams within the staff persons scope, as needed.

Note: Employees are held accountable for all duties of this job. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.

Education, Knowledge, Skills & Experience Required:

• Master's degree in a related field (psychology, counseling, human services, social work, etc.)
• CAS (CAC II/III) or LAC required. LPC, LCSW, LMFT or comparable license preferred.
• Two years of relevant experience and education required coordinating or providing input to a utilization management program.
• Position requires experience completing and applying the American Society of Addiction Medicine (ASAM) Criteria, including its Dimensions and Severity Ratings, demonstrate competency with relevant computer applications and electronic health record systems, ability to analyze and organize data, good clinical writing skills, presentation/teaching experience, and ability to maintain a high level of organization, efficiency and compliance with utilization management standards.
• Bilingual preferred.
• In this position, applicants can expect to be responsible for maintaining the program waitlist including outreach and coordination for screening and admissions, care coordination with referral sources and community partners, completing timely screenings of referrals using the ASAM, completing census emails twice per week, maintaining a census of at least fifteen (15) clients, obtaining and maintaining authorizations or gathering necessary information for use of Indigency funds, and submitting discharge summaries, as needed.

Salary Grade 14 - $63,800 - $81,200

Additional Salary Information*:

• The salary range above is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE.*

Application Deadline: 10/3/2025. Review of applications will begin immediately.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.