Supervisor, Behavioral Health Utilization Management
Core
Supervises behavioral health utilization review clinicians to ensure appropriate care for members and manages day-to-day activities of the utilization management team.
Role type
Senior IC behavioral health utilization management supervisor
Builds
Behavioral health care utilization review services for members
Domain
Healthcare + Behavioral Health Utilization Management
Required skills
Behavioral health utilization management principles, Medical necessity criteria, Regulatory compliance (Texas Administrative Code, LMHAs guidelines), Retrospective audits, Performance management, Process improvement, Team coaching, Policy development
Preferred skills
Prior leadership experience, Medicaid and community mental health knowledge, Foster care/Child Protective Services familiarity, Change management
Technologies
None stated
Responsibilities
Monitor BH utilization review clinicians for compliance, Track UM BH resources for performance/quality/efficiency standards, Resolve complex BH care member issues, Identify process and quality improvement opportunities, Develop and implement UM policies and procedures, Evaluate team performance and provide feedback, Assist with onboarding, hiring, and training, Act as primary contact for escalated issues, Lead and manage others in a matrixed environment, Champion change within scope of responsibility
Seniority
Senior, hands-on IC with team leadership