SUD Clinical Manager at NorthCare Network

Marquette, Michigan, United States -

Full Time

Start Date

Immediate

Expiry Date

05 May, 26

Salary

95160.0

Posted On

04 Feb, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Leadership, Substance Use Disorders, Utilization Management, Managed Care, Quality Improvement, Regulatory Standards, ASAM Criteria, Policy Writing, Medical Necessity Evaluation, Authorization Determination, Clinical Consultation, Human Services, Management, SUD Treatment Providers, Provider Network Liaison, Treatment Service Delivery

Industry

Mental Health Care

Description

Description STATUS/HOURS: Competitive Wage, plus full-time benefits. Regular full-time/80 hours biweekly SALARY RANGE: $70,491.20 to $95,160.00. Starting salary will be determined based on education, certifications, and experience. LOCATION: Marquette, Michigan - Many positions offer a hybrid work schedule with supervisor approval. ABOUT US: NorthCare Network is a Specialty Prepaid Inpatient Health Plan (PIHP) located in Marquette, Michigan and is responsible for the management and service array available to residents of Michigan’s Upper Peninsula with behavioral health needs covered by Michigan Medicaid and specialty grants for substance use disorder services. RESPONSIBILITIES INCLUDE: Under the supervision of the SUD Services Director, this position oversees clinical programming and serves as a liaison for the Provider Network. The SUD Clinical Manager is responsible for clinical leadership within NorthCare Network for substance use disorder (SUD) managed care services and supervising SUD Access staff. The position requires extensive involvement with the SUD Treatment Providers in the NorthCare Provider Network. This position oversees SUD treatment service delivery, ensures adherence to clinical and regulatory standards, ensures treatment services are provided according to ASAM criteria, and writes directives/policies as needed. This employee shall also participate in the development of practices that conform to regulatory standards and implementation of Quality Improvement and Utilization Management plans throughout the Prepaid Inpatient Health Plan (PIHP) region. This position evaluates medical necessity of treatment and determines authorizations for type and level of care and will provide clinical consultations for other clinicians conducting required Managed Care functions. Requirements QUALIFICATIONS: Master’s Degree and Licensure in Human Services field required. Minimum 3 years of experience working in a Human Services field required. MCBAP (CCS level) or UMICAD certification required or must be obtained. Experience working with substance use disorders and utilization management is required. Three years of management and/or leadership experience is preferred. Knowledge preferred in the following areas: MDHHS managed care plan, managed care procedures (authorizations, claims management, clinical best practice guidelines), CMS waiver in Michigan, Balanced Budget Act, Deficit Reduction Act, CMHSP/SUD System in Michigan, Managed Care Practices and Medicaid Regulations.

Responsibilities

The SUD Clinical Manager oversees clinical programming and serves as a liaison for the Provider Network, ensuring adherence to clinical and regulatory standards. This position also evaluates medical necessity of treatment and provides clinical consultations for other clinicians.