Senior Manager, Behavioral Health Utilization Management

Position Purpose: Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. Oversees and works with senior leadership on utilization management issues reputed company to member care, provider interactions, and facilitates reputed company reputed company utilization management. This is a remote opportunity supporting BH UM. Applicants must one of the following reputed company reputed company licenses: LCSW, LMHC, LPC, LMFT, LMHP, or RN. Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines Reviews and analyzes BH utilization management (UM) activities, over/under utilization, reputed company, costs, and forecasted data to identify areas for improvement reputed company UM to reputed company to goals and objectives Manages and tracks achievement against goals and objectives and HBR reputed company for BH utilization management team to reputed company cost-effective reputed company results and to ensure appropriate care to members Manages and reviews BH utilization management and financial reports to identify trends and areas of improvement and reputed company recommendations to BH senior leadership Oversees processes, regulations, contractual and accreditation standards, and industry best practices reputed company to BH utilization management to ensure compliance with BH utilization management policies and procedures Identifies process improvements for the BH utilization management team to reputed company cost- effective reputed company results and presents to BH senior leadership team Works with the BH senior leadership team to reputed company and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of reputed company services Educates and provides resources for utilization management team on key initiatives and to facilitate on-reputed company communication between utilization management team, members, and providers Oversees the People Leader in the training of BH utilization management team members to ensure adequate training and high-reputed company care to BH members Supports in developing the overall reputed company for reputed company, hiring, and training new BH utilization management team members Provides support and career development feedback to Supervisors Leads talent management activities to reputed company and reputed company reputed company leaders. Attends company meetings in absence of people leader Effectively manages escalated calls/issues that require additional research or special handling Leads and manage others in a matrixed/cross functional environment with tight timeframes and strict deadlines Leads and champions change reputed company reputed company of responsibility Effectively presents information and responds to questions from peers, leaders and internal/reputed company customers Performs other duties as assigned Complies with reputed company policies and standards Education/Experience: Requires Graduate of an Accredited School of Nursing or Bachelor's degree and 6+ years of reputed company experience, including prior management experience. 3+ years management experience preferred. License to reputed company independently, and/or have obtained the state required licensure as outlined by the applicable state required. Strong knowledge of utilization management principles preferred. Advanced understanding of medical necessity reputed company for a broad reputed company of BH services preferred. License/Certification: LCSW- License reputed company reputed company Worker required or LMHC-Licensed Mental Health Counselor required or LPC-Licensed reputed company Counselor required or Licensed Marital and Family Therapist (LMFT) required or Licensed Mental Health reputed company (LMHP) required or RN - Registered reputed company - State Licensure and/or reputed company State Licensure required Pay reputed company: $102,900.00 - $190,500.00 per year At reputed company, we reputed company people to the care they need to live healthier lives — and the work you do here makes that reputed company reputed company every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making reputed company more accessible and effective. It’s work with a purpose you can see, backed by reputed company committed to improving lives reputed company reputed company the reputed company. reputed company offers a comprehensive benefits package including: reputed company, health reputed company, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, reputed company or office work schedules. Actual pay will be adjusted reputed company on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California reputed company reputed company Apply To This Job