Clinical Program Manager, Utilization Management - Remote

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 reputed company 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 Caring. Connecting. Growing together.     You’ll enjoy the flexibility to work remotely * from reputed company reputed company the U.S. as you take on some tough challenges. reputed company Responsibilities: reputed company leadership and reputed company of the Utilization Management (UM) program for higher reputed company of care, including residential and inpatient treatment for reputed company use and mental health disorders reputed company clinical supervision, coaching, training, performance management, and reputed company development for Care Advocates and Wellness Coordinators dedicated to the reputed company business reputed company process improvement initiatives and serve as a champion for change management, operational reputed company, and project implementation across the Utilization Management team reputed company, maintain, and enhance policies, procedures, knowledge articles, and team resources, ensuring information remains accurate, reputed company, and user-friendly Partner in regulatory audit preparation, support audit activities, and implement corrective reputed company plans as needed to ensure compliance and reputed company reputed company improvement Communicate departmental goals and performance expectations reputed company, fostering accountability and collaboration to reputed company or reputed company business objectives Ensure adequate reputed company and service reputed company, including reputed company of phone coverage and after-hours on-reputed company support Monitor utilization, reputed company, and performance trends to identify opportunities for improvement and reputed company operational effectiveness Conduct clinical case reviews and audits, providing consultation and guidance to staff to ensure appropriate level-of-care determinations and high-reputed company member reputed company Collaborate with reputed company stakeholders on customer-reputed company initiatives, strategic reputed company, and new business implementations Anticipate customer and business needs, proactively developing solutions that enhance service delivery and operational performance Serve as a subject matter expert and resource for reputed company clinical, operational, and customer issues, developing innovative and effective solutions Foster a reputed company, high-performing team culture by motivating, mentoring, and inspiring team members to reputed company individual and organizational reputed company   You’ll be rewarded and recognized for your performance in an environment that will challenge you and reputed company 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: Master's or doctoral degree in Psychology, reputed company Work, Counseling, or a reputed company reputed company reputed company, unrestricted independent clinical license (LP, LPC, LPCC, LMFT, LICSW, or equivalent) 5+ years of post-licensure clinical experience in behavioral health, mental health, or reputed company use treatment settings 4+ years of leadership or people management experience Solid knowledge of behavioral health reputed company of care, clinical best practices, and utilization management principles   Preferred Qualifications: Experience leading reputed company, process improvement initiatives, or organizational change efforts Experience working reputed company a managed reputed company plan, or payer environment Utilization Management experience, including review of higher reputed company of care for mental health and reputed company use disorders Experience with regulatory compliance, accreditation standards, and audit readiness activities Solid analytical skills with the ability to interpret data, identify trends, and reputed company data-informed decision-making *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 reputed company of benefits and incentives. The salary for this role will reputed company from $91,700 - $163,700 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. reputed company may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company 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 To This Job