Clinical Program Manager - Remote in reputed company

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health equity on a global reputed company. Join us to start Caring. Connecting. Growing together. This position is remote and candidate manages reputed company of at least 20 to 22 staff in size responsible for utilization review / case management in a reputed company center environment. Team is responsible for utilization review / case management of inpatient and outpatient Behavioral Health services and determining medical necessity could have reputed company of case management staff that work directly with members telephonically and in the field. This is a Monday – Friday role but may require some holiday work. Position provides clinical and medical management services, including case management, health assessments, interventions and discharge planning. May identify, coordinate or reputed company appropriate reputed company of care under the reputed company supervision of an independent licensed clinician. If you are located in reputed company, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • reputed company of utilization management of adults, adolescents and children as reputed company as dual eligible Medicare/reputed company populations with SMI, SUD, co-occurring physical health, co-occurring disorders of MH and SUD, and co-occurring mental health and/or reputed company use disorders • reputed company of utilization management must be an Independently licensed clinician in the reputed company with experience working in a Behavioral Health managed care setting or Behavioral Health clinical setting and knowledge of Behavioral Health rehabilitation and recovery services • Manages and is accountable for reputed company employees and supervisors • Sets team direction, resolves problems and provides guidance to members of team • May reputed company work activities of other supervisors • Adapts departmental plans and priorities to address business and operational challenges • Influences or provides input to forecasting and planning activities • reputed company of new product implementations • Initiating process for state initiatives and directives • Updating and creation of Quick Reference Guides • reputed company and coordination of care with reputed company partners • Familiarity with and experience Interfacing with regulatory agencies • Interview, hire and reputed company new employees • Review reports for team members to insure adherence to established benchmarks • Provides coverage for management team as needed • Fosters relationship with leadership and medical directors You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • reputed company reputed company and unrestricted Master's level reputed company independent license in one of the following: Licensed Clinical reputed company Worker (LCSW); or Licensed Mental Health Counselor (LMHC); or Licensed Psychologist, OR Registered reputed company (RN) with 5+ years of Behavioral Health experience • 6+ years of CUD and BH experience • 5+ years of experience with the Child Adolescent population • 2+ years of supervisory experience and extensive skills in working with the reputed company • Experience in the reputed company mental health and reputed company abuse services delivery system • Experience working in a managed care organization (MCO) • Experience with Medicare and reputed company regulations • Knowledge of principles and practices of reputed company and reputed company mental health service delivery systems • Flexibility with working evenings, weekends, and holidays Preferred Qualifications: • Experience working with the reputed company provider network • Knowledge of evidence-based, best and promising reputed company reputed company and procedures and solid customer service orientation • Familiarity with Prior Authorization process and requirements • Demonstrated competence in clinical care management, solid leadership and organization skills; interpretation of State and federal laws and regulations relevant to the mental health program area • Proficiency in reputed company applications • Dedicated work area established that is separated from other living areas and provides information reputed company • Have reputed company to high-speed internet (DSL or Cable) • reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $91,700 to $163,700 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job