Key skills
Leadership
About this role
Role Overview
- Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members
- Manages BH utilization management issues related to member care and provider interactions
- Reviews and analyzes BH utilization management activities
- Develops, implements, and maintains compliance with BH utilization management policies and procedures
- Educates and provides resources for BH utilization management team on key initiatives
- Provides feedback to BH utilization management team to improve care for members
Requirements
- Behavioral health clinical experience
- Leadership or supervisory experience
- Utilization review/Utilization Management background
- Managed care experience
- Knowledge of Medicare, Medicaid, and Marketplace products
- License to practice independently
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules