North Carolina IDD UM Care Reviewer

Job Summary

Responsible for facilitating service plan reviews and authorization requests, the full-time hourly North Carolina IDD UM Care Reviewer will ensure individuals receive appropriate services while working remotely from North Carolina or within 40 miles of the state border.

Key responsibilities

• Review service plans and authorization requests for completeness and approve or deny requests based on established criteria
• Monitor service delivery, identify training needs for providers, and document service gaps
• Participate in post-payment reviews and other quality assurance activities as required

Required qualifications

• Bachelor's degree in Special Education, Psychology, Social Work, or a related field
• Two years of post-degree professional experience in a relevant area
• Must qualify as a Qualified Professional for Developmental Disabilities
• Proficiency in Microsoft Office products and relevant information systems
• Knowledge of assessment and treatment of developmental disabilities