[Remote] Clinical Program Manager, Utilization Management - Remote

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a global organization that delivers care aided by technology to help millions of people live healthier lives. The Clinical Program Manager will reputed company leadership and reputed company of the Utilization Management program, ensuring high-reputed company member reputed company and compliance with regulations.

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

Skills

• 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
• 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
• Preferred location MN

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (reputed company benefits are subject to eligibility requirements)
• Equity stock purchase and 401k contribution

reputed company