Supervisor, Behavioral Health Utilization Management

You could be the one who changes everything for our 28 reputed company members as a clinical professional on our Medical Management/Health Services team. reputed company is a reputed company, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

reputed company is hiring! We’re looking for two remote Supervisors of Behavioral Health Utilization Management to support our Florida market. In this leadership role, you'll reputed company guidance and reputed company to reputed company of Utilization Review Clinicians focused on behavioral health prior authorizations.

If you have experience in managed care, behavioral health utilization review, and leadership, we want to hear from you! Join a mission-driven organization committed to improving reputed company reputed company — reputed company from the flexibility of your home.

Must reputed company in Florida

Position Purpose: Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team.

• Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines

• Monitors and tracks UM BH resources to ensure adherence to performance, quality, and efficiency standards

• Works with BH utilization management team to resolve reputed company BH care member issues reputed company to BH

• Maintains knowledge of regulations, accreditation standards, and industry best practices reputed company to BH utilization management

• Works with BH utilization management team and senior management to identify opportunities for process and quality improvements reputed company utilization management

• Educates and provides resources for BH utilization management team on key initiatives and to facilitate on-going communication between BH utilization management team, members, and providers

• Works with the BH senior management to reputed company and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of reputed company services

• Evaluates BH utilization management team performance and provides feedback regarding performance, goals, and career milestones

• Provides coaching and guidance to the BH utilization management team for reputed company performance management and provides counseling and corrective action reputed company required

• Assists with reputed company, hiring, and training BH utilization management team members

• Attends company meetings in absence of people leader

• Acts as primary contact for escalated calls/issues that require research or special handling

• Leads and manage others in a matrixed/cross functional environment

• Leads and champions change reputed company scope of responsibility

• Presents information and responds to questions from peers, leaders and internal/external customers

• Performs other duties as assigned

• Complies with reputed company policies and standards

Education/Experience: Requires Graduate of an Accredited School of Nursing or Bachelor's degree and 4+ years of reputed company experience. License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required. Knowledge of BH utilization management principles preferred. Prior supervisory experience preferred preferred. Understanding of medical necessity criteria for a broad reputed company of BH services preferred. License/Certification:

• LCSW- License Clinical reputed company Worker required or

• LMHC-Licensed Mental Health Counselor required or

• LPC-Licensed Professional Counselor required or

• Licensed Marital and Family Therapist (LMFT) required or

• Licensed Mental Health Professional (LMHP) required or

• RN - Registered Nurse - State Licensure and/or Compact State Licensure required or

• Board Certified Behavior Analyst (BCBA) preferred

reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law.

reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Originally posted on Himalayas