Supervisor, Behavioral Health Utilization Management

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $75.3k - $135.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Supervises the BH utilization review clinicians • Ensures appropriate care for members • Monitors compliance with guidelines • Resolves complex BH care member issues • Maintains knowledge of regulations and best practices • Identifies opportunities for process and quality improvements • Educates BH utilization management team on key initiatives • Develops and implements UM policies and procedures • Evaluates team performance and provides feedback • Assists with onboarding and training

🎯 Requirements

• Graduate of an Accredited School of Nursing or Bachelor's degree • 4+ years of related experience • License to practice independently and/or have obtained the state required licensure • Knowledge of BH utilization management principles preferred • Prior supervisory experience preferred • Understanding of medical necessity criteria for a broad range of BH services preferred • LCSW, LMHC, LPC, LMFT, LMHP, or RN state licensure required

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules