• Review job profiles and applications submitted by candidates • Assess candidate fit through evaluation of interviews and assessment results • Decide which candidates can join the 10x community based on predefined criteria • Collaborate with the recruitment and operations teams to ensure a seamless onboarding process • Maintain accurate records of candidate evaluations and progress

Role Description The UM Clinical Specialist-Behavioral Health performs professional and administrative work, primarily utilization reviews, utilization management, and active care management to ensure economical and effective consumer service delivery by PHIP enrolled network providers. The position is responsible for providing medical necessity reviews of individualized service plans and requests for authorization of services to ensure consumers receive services in the least restrictive, most integrated setting appropriate to the individual’s needs. The primary role is to review for services under the Medicaid B waiver and state-funded benefits; complete related work as required. This position is full-time remote. The selected candidate must reside in North Carolina. Some travel for onsite meetings may be required. Responsibilities & Duties - Utilization Reviews and Management - Independently conducts medical necessity reviews of service requests submitted by service providers against developed clinical guidelines within contractually mandated turn-around times. - Conducts utilization reviews to monitor adherence to clinical practice guidelines and best practice standards and to determine if services were delivered as requested. - Engages in care management activities to ensure individuals receive appropriate referral for treatment including consumer and provider follow-up calls, case staffing with psychologists and medical staff. - Monitors consumer person-centered plans to ensure that effective treatment interventions are utilized, providing consultation to treating providers when person-centered plans require adjustments to better meet consumer needs. - Monitors and reports consumer and provider specific over/under utilization. - Conducts utilization reviews to monitor for over/under utilization. - Program Operation and Management - Identifies high-risk consumers and those with special health care needs for referral to Care Coordination and case escalation. - Provides linkage, authorizations, and level of care determinations, assisting providers and Care Coordinators with creative problem solving to recommend alternative approaches to care. - Ensures compliance with care management and quality improvement policies and procedures, utilization review laws and regulations, state standards. - Promotes access to appropriate, effective, and quality treatment. - Monitors for undesirable performance or deviations of practice standards through care management activities that may have a negative impact on consumers. Responds through additional follow-up with consumers and providers, provider technical assistance, and/or referral to other departments within the MCO. - Administrative Functions - Notifies members of adverse benefit determinations while preserving members’ Due Process rights. - Engages in routine follow-up to ensure consumers are engaged in treatment and services are being delivered as requested. - Documents utilization review decisions in computerized authorization management system. - Maintains professional licensure. - Engages in training as needed to stay informed of changes in best practice for supporting the needs of individuals with MH/SUD/IDD. Qualifications - Required: - Master’s degree in a Human Services field (such as Psychology, Social Work, or Counseling) and at least five years of post-degree progressive experience providing similar services to the population served (MH/SUD). - Current and active license issued by a North Carolina Professional Board, as a LCSW, LCAS, LP, LPA, LMFT, LCMHC, or RN. - A master's degree in psychiatric nursing which provides the knowledge, skills, and abilities needed to perform this work; or graduation from a State accredited school of nursing and two years of experience in psychiatric nursing which provides the knowledge, skills, and abilities needed to perform the work; or an equivalent combination of education and experience. - Preferred: - Experience in the public behavioral healthcare field is highly desired due to the complexity of the work. - Experience in a UM environment in Behavioral Healthcare would be valuable for this employee. Knowledge, Skills, & Abilities - Considerable knowledge of case management principles, practices, and applications. - Considerable knowledge of agency and community programs and services which affect clients and applicants. - Knowledge of state and federal client rights protection statutes and regulations applicable laws and regulations including but not limited to URAC, applicable Code of Federal Regulations, and NC Administrative Code. - Effective written and oral communication skills and interpersonal and presentation skills. - Ability to identify rights protection complaint issues; ability to set, monitor, and evaluate standards for quality and to assess plans to measure how they meet the needs of individual clients. - Considerable knowledge in DSM 5 diagnostic criteria. - Ability to manage time, prioritize work, and use problem-solving approaches. - Ability to coordinate effectively with staff from various agencies as well as inter-departmental. - Ability to read, analyze, and interpret regulations, policies, and procedures. - Ability to operate computer equipment and generate reports and records; ability to express ideas clearly and concisely orally and in written documents. - Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) is required. Salary Range $68,227 - $86,990/Annually. Exact compensation will be determined based on the candidate's education, experience, external market data, and consideration of internal equity. Benefits - Medical, Dental, Vision, Life, Long Term Disability. - Generous retirement savings plan. - Flexible work schedules including hybrid/remote options. - Paid time off including vacation, sick leave, holiday, management leave. - Dress flexibility.

• Be a strategic partner in delivering on-time and quality translations to IQVIA clients • Carefully adhere to provided material and instructions to meet the requirements of the clients • Research industry-specific terminology to properly reflect the meaning and tone of the source content • Cross-reference specialized glossaries and translation tools to check the quality of the translation • Quality Check translation jobs before delivery for grammar, spelling and punctuation accuracy • Work with the IQVIA™ Translation Services team to identify gaps in instructions or any external issue that may affect the commitment to the client. • Flag project-specific queries in a timely manner • Be the point of contact for IQVIA™ Translation Services to assist with quality and on-time delivery investigations related to feedback. • Maintain close communication with Project Management and Vendor Management teams with regards to own capacity

• Lead full-cycle recruitment for assigned salaried roles • Partner with hiring managers and HR to define role requirements • Proactively source and engage candidates through various methods • Deliver a high-quality candidate experience through consistent communication • Maintain accurate candidate and requisition data within the ATS