Centene Corporation · 11 hours ago
Supervisor, Behavioral Health Utilization Management
United States
Full-time
Remote
Mid, Senior Level
$75K/yr - $135K/yr
4+ years expCentene Corporation is a diversified national organization seeking a Supervisor for their Behavioral Health Utilization Management team. The role involves supervising clinicians to ensure appropriate care for members, monitoring compliance with guidelines, and leading the team to enhance performance and quality in behavioral health services.
Hospital & Health Care
Responsibilities
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 complex BH care member issues related to BH
Maintains knowledge of regulations, accreditation standards, and industry best practices related to BH utilization management
Works with BH utilization management team and senior management to identify opportunities for process and quality improvements within 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 develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare 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 optimal performance management and provides counseling and corrective action when required
Assists with onboarding, 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 within scope of responsibility
Presents information and responds to questions from peers, leaders and internal/external customers
Performs other duties as assigned
Complies with all policies and standards
Qualification
Required
Graduate of an Accredited School of Nursing or Bachelor's degree and 4+ years of related experience
License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required
LCSW- License Clinical Social 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) required
Preferred
Knowledge of BH utilization management principles preferred
Prior Supervisory Experience Preferred
Understanding of medical necessity criteria for a broad range of BH services preferred
Benefits
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
A flexible approach to work with remote, hybrid, field or office work schedules
Company
Centene Corporation
Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Beth Johnson
President and CEO, Coordinated Care
Clyde White
President & CEO (New Hampshire Healthy Families)
Recent News
Business Journals
2024-05-06
FierceHealthcare
2024-04-28
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