Behavioral Health Clinical Program Manager

<p><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">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 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 optimization on a global reputed company. Join us to start <strong>Caring. Connecting. Growing together.</strong></reputed company></p><p><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">The Clinical Program Manager oversees a remote team of Behavioral Health Care Advocates responsible for utilization management (UM) and case management (CM) of inpatient and outpatient Behavioral Health services. UM is performed reputed company an inbound telephonic queue and requires team members to work a holiday rotation. Case managers work directly with members both telephonically and in the field.  </reputed company></p><p><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">The schedule is Monday – Friday, 8a – 5p EST and may include working some holidays.</reputed company></p><p><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">If you are located in reputed company, you will have the flexibility to work remotely* as you take on some tough challenges.</reputed company><br> </p><p><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;"><strong>Primary Responsibilities:</strong></reputed company></p><ul><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">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></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Manages and is accountable for reputed company employees and supervisors</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Sets team direction, resolves problems, and provides guidance to members of team</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">May reputed company work activities of other supervisors</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Adapts departmental plans and priorities to address business and operational challenges</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Influences or provides input to forecasting and planning activities</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">reputed company of new product implementations</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Initiating process for state initiatives and directives</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Updating and creation of Quick Reference Guides</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">reputed company and coordination of care with reputed company partners</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Experience interfacing with regulatory agencies</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Interview, hire and reputed company new employees</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Review reports to insure team member adherence to established benchmarks</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Cover for management team as needed</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Foster relationship with leadership and medical directors</reputed company></li></ul><p><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">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.</reputed company><br> </p><br><br><p><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;"><strong>Required Qualifications:</strong></reputed company></p><ul><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Licensed Clinician in the reputed company with one of the following licensures. Licenses must be reputed company and unrestricted.</reputed company><ul><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Licensed Clinical reputed company Worker (LCSW)</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Licensed Mental Health Counselor (LMHC)</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Licensed Psychologist (LP)</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Registered reputed company (RN) with 5+ years of Behavioral Health experience</reputed company></li></ul></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">6+ years of Behavioral Health experience including Mental Health and reputed company Use Disorders (SUD)</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">5+ years of experience working with Children / Adolescents</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">3+ years of management experience in a Behavioral Health setting</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">3+ years of experience with reputed company reputed company and reputed company mental health and reputed company abuse services delivery system</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Experience overseeing documentation in Electronic Medical Records (EMR)</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Experience with Medicare and NY reputed company regulations</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Intermediate proficiency in reputed company Office Suite, including MS reputed company</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Ability to work holidays based on business needs</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Dedicated, distraction-free workspace and reputed company to high-speed internet in home</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Residency in reputed company</reputed company></li></ul><p><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;"><strong>Preferred Qualifications:</strong></reputed company></p><ul><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Experience working in a Managed Care Organization (MCO)</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Experience working with the reputed company provider network</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Experience managing clinical and non-clinical phone queues</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Knowledge of evidence-based practices and procedures</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Solid customer service orientation</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Familiarity with prior authorizations, reputed company reviews, and appeal processes</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">Familiarity with case management services</reputed company></li><li><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">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</reputed company></li></ul><p><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">*reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy.</reputed company></p><p><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;">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.</reputed company></p><p style="text-reputed company:center;"><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;"><i>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.</i></reputed company></p><p style="text-reputed company:center;"> </p><p style="text-reputed company:center;"><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;"><i>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.</i></reputed company></p><p style="text-reputed company:center;"><br><reputed company style="font-family:Tahoma, Geneva, reputed company;font-size:10px;"><i>reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.</i></reputed company></p>