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Manager of Utilization Management (Full Time)

Job Description
Organization: 
Behavioral Healthcare Inc.
Organization Type: 
Start-up nonprofit
Job Location: 
Statewide
Type of Job: 
Full-time
Job Category: 
Executive
Job Description: 

Behavioral Healthcare (BHI) is a nationally accredited (NCQA), non-profit managed care company committed to excellence in delivering mental health services; working with our centers and contracted providers to provide the best possible services and environment for our members. We strive to promote recovery by focusing on the unique needs, strengths, and hopes of members and their support networks.  BHI is a behavioral health organization (BHO) primarily serving Medicaid members in Adams, Arapahoe and Douglas Counties, and the City of Aurora. Through its efforts, BHI has developed a statewide reputation in mental health and recovery, and as a result is also partnered with the State of Colorado Mental Health Institutes in Pueblo and Fort Logan in assisting patients in their recovery and reintegration into the community.

This position maintains responsibility for managing all Utilization Management (UM) functions within the BHI system and ensures that staffing is appropriate for 24/7 coverage to carry out the UM functions. The Manager ensures that the department consistently applies medical necessity criteria, as well as national, state and accreditation standards when making utilization determinations.  As such, this position provides management, supervision, and collaboration with a highly skilled team to monitor and coordinate utilization of BHI services.  In addition, the Manager will be directly involved in the utilization management of a caseload and is responsible for clinical review and authorization or denial of services to members, participating in complex case reviews with multidisciplinary teams, disposition planning, coordinating benefits and care among providers and systems.

If you are among the best, you will have the opportunity to work with a talented, inspired and energetic workforce. Fully qualified candidates may expect competitive pay, commensurate with experience, in addition to the typical benefits that you would find at other larger, for profit companies. Some of the benefits that you don't typically find at other companies that BHI offers its employees include:

Excellent health insurance starting at $1/month
Good dental insurance starting at $1/month
Employer paid short-term disability insurance
Employer paid long-term disability insurance
Employer paid long-term care insurance
401k Match – 100% up to 5% annual salary
20 days of PTO per year–That's four weeks!
9 paid holidays per year
Extended illness bank

QUALIFICATIONS, EXPERIENCE & SKILLS:  Minimum requirements to competently perform the key responsibilities of this job, work experience, education and other knowledge, skills, and abilities.  Specify whether the qualification is required or preferred.

Education:  Bachelor's Degree in psychology, social work or healthcare related field. (required).  Master's Degree preferred.
Years of Experience:

                1.  Five (5) years of experience of direct patient care in mental health. (Required)

                2.  Two (2) years' experience in utilization management required preferably in managed care industry.

                3.  Two (2) years of management experience preferably in the mental health field. (Required)

Certificates, Licenses, Registrations: Eligible for or currently hold a Colorado License, without sanctions, required in a behavioral health discipline such as LPC, LCSW, LMFT, PsyD, PhD, LP, RN.
Leadership/Accountability: Works with integrity and ethically, inspires the trust of others. Demonstrated ability to accept ownership, take initiative and assume responsibility; does not blame or pass problems off onto others but takes the initiative to get the right people involved and to resolve matters quickly and effectively.

Please visit BHIcares.org to view the full job description.

 

For more information, or to apply now, you must go to the website below. Please DO NOT email your resume to us as we only accept applications through our website.

https://www.applicantpro.com/j/560933-40435

Areas of Responsibility

This position maintains responsibility for managing all Utilization Management (UM) functions within the BHI system and ensures that staffing is appropriate for 24/7 coverage to carry out the UM functions. The Manager ensures that the department consistently applies medical necessity criteria, as well as national, state and accreditation standards when making utilization determinations.  As such, this position provides management, supervision, and collaboration with a highly skilled team to monitor and coordinate utilization of BHI services.  In addition, the Manager will be directly involved in the utilization management of a caseload and is responsible for clinical review and authorization or denial of services to members, participating in complex case reviews with multidisciplinary teams, disposition planning, coordinating benefits and care among providers and systems.

Requirements/Qualifications
  • Bachelor's Degree in psychology, social work or healthcare related field. (required).
How To Apply

For more information, or to apply now, you must go to the website below. Please DO NOT email your resume to us as we only accept applications through our website.

https://www.applicantpro.com/j/560933-40435

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