Top cities
View all citiesBrowse
Free Resume Checker
Build your resume in your free account, then run the resume checker for an instant score plus healthcare-specific findings on licensure and clinical experience.
Build your resumeFree tools for healthcare professionals
Children's Network of Hillsborough·Egypt Lake-Leto, Florida
Utilization Management Specialist
The Utilization Management Specialist acts as a liaison between organizations to facilitate service needs for children and families. They are responsible for processing service authorizations, tracking assessments, and maintaining accurate client records.
Prepare initial authorization of paid, purchased, and contracted and Medicaid funded services funded by the Lead Agency ensuring that authorizations are generated quickly to facilitate initiation of services to children and families. Works with the Point of Contact (POC) to serve as the central point of contact for case managers in referring children for Comprehensive Behavioral Assessments (CBAs), other behavioral assessments as needed and mental health services. Process and track the progress of Comprehensive Behavioral Health Assessment (CBHA) referrals. Receive completed assessments and process service authorizations once approved. Cultivates effective communications and working relationships with network of service providers. Maintain accurate client records of service requests, authorizations, and payments processed. Evaluate and process flex fund and community development requests. Track process of referrals for Suitability Assessments (QE), adherence to time frames, including level of care; admit dates, changes in level of care, name of therapeutic providers. Processes invoices from providers for payments. Work together as a team with co-workers to streamline processes and maintain unit efficiency and quality of work. Monitors email on daily basis. Circulate pertinent information to unit staff members. Maintain regular in-office attendance to perform essential job functions, collaborate effectively with team members, participate in meetings, and provide timely support to agency operations and service delivery. Perform other duties as assigned to support departmental and agency goals, as needed and appropriate to the position. Working Hours Children’s Network of Hillsborough’s standard business hours are 8:00 a.m. to 5:00 p.m., Monday through Friday. This position is an in-office based position that averages 40 hours per week. Work hours may vary outside of these standard hours, including evenings and weekends, as needed to meet operational demands. All hours worked will be compensated in accordance with the Fair Labor Standards Act (FLSA) and agency policies, including applicable overtime and other compensation requirements. Travel Travel within and outside of Hillsborough County is required. Training All employees are required to complete fifteen (15) hours of training annually, which may be completed online or in a classroom setting. Employees who hold a credential or license relevant to their position must ensure that all training and continuing education requirements are met to maintain their credential or licensure Supervisory Responsibilities This position does not have supervisory responsibilities QualificationsEducation and Experience Bachelor’s degree (B.A.) from a four-year accredited college or university; Florida Child Welfare Certification (Case Management or Investigations) is preferred. Other Qualifications Minimum of one (1) year of experience in Child Welfare, social services, behavioral health care, or related field Excellent organizational and problem-solving skills Self-motivated with the ability to manage various work assignments simultaneously Ability to establish and maintain positive working relationships with others Knowledge of local community services is desired Skills and Abilities Must be able to operate standard modern office machinery, including fax, telephone, calculator, computer, scanner, printer, copier and mail machine. Minimum typing speed of 45 wpm; excellent word processing skills. Must be competent with Microsoft Office Suite programs, including Word, Excel, Power Point, Access, Publisher and Outlook. Must be competent with basic e-mail protocol and procedures including sending, receiving, replying, attachments, and meeting scheduling; excellent written and oral communication skills; effective listening skills; ability to work as a team member, and the ability to work in a multi-cultural environment. Must abide by the highest standards of confidentiality. Pre-employment Requirements Valid driver’s license required, with proof of insurance Driver’s license check is a requirement Criminal background screening (fingerprinting) (Local Law Enforcement and FBI/FDLE) Drug Screening is a requirement Children’s Network participates in E-Verify Other Requirements Language Skills Ability to read, analyze, and interpret common scientific and technical journals, financial reports, legal documents, and/or governmental regulations. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conform to prescribed style and format. Ability to effectively present information and respond to questions from groups of managers, clients, public groups, and/or boards of directors. Ability to speak effectively before groups of customers or employees. Mathematical Skills Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables. Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to be proactive, as well as handle problems involving several concrete variables in standardized situations. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job requires the ability to sit for extended periods; walk; stand; use hands to finger, handle or feel; reach with hands and arms; stoop, kneel or crouch; talk and hear. This job requires visual acuity sufficient to read and to operate standard modern office machines. The employee must occasionally lift and/or move up to 25 pounds. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This is administrative work in an indoor office environment with a moderate noise level (business machines, printers, computers, telephones).
A bachelor's degree and at least one year of experience in child welfare, social services, or behavioral health are required. Candidates must possess strong organizational skills, proficiency in Microsoft Office, and a valid driver's license.
Market context
In Florida, behavioral-health roles are typically in steady demand across community clinics, schools, and care settings serving diverse populations. Competition often centers on licensure status, supervised experience, and the ability to work well with interdisciplinary teams while applying mental health ethics and cultural awareness. Review the full posting carefully and confirm your Master’s degree, Registered Intern License, and communication experience; this platform’s AI-summarized requirements and benefits can save you time by condensing the original job description.
Children's Network of Hillsborough
Nurse Care Coordinator
Egypt Lake-Leto, Florida$31 - $31/hr
13 days ago
Children's Network of Hillsborough
Nurse Care Coordinator- Part Time
Egypt Lake-Leto, Florida$31 - $31/hr
13 days ago
Children's Network of Hillsborough
Clinical Support Specialist
Egypt Lake-Leto, Florida$23 - $23/hr
1 month ago