Supervisor, Behavioral Health Utilization Management

This is a fully remote position, open to applicants in Florida.

📋 Description

• Oversee the activities of utilization review clinicians in behavioral health and manage the daily operations of the utilization management team.

• Ensure adherence to relevant guidelines.

• Monitor and assess utilization management resources against standards of performance, quality, and efficiency.

• Address complex issues related to behavioral health care members.

• Stay informed about regulations, accreditation standards, and industry best practices.

• Identify opportunities for process enhancements and quality improvements.

• Educate the team and provide resources regarding essential initiatives.

• Formulate and execute policies, procedures, and guidelines for utilization management.

• Assess team performance and offer feedback related to objectives and career development.

• Mentor and guide team members; provide counseling and corrective measures when necessary.

• Support onboarding, recruitment, and training efforts.

• Represent the team in company meetings in the absence of the team leader.

• Serve as the primary contact for escalated inquiries and issues.

• Lead and advocate for change within the defined scope of responsibility.

• Present information and address questions from colleagues, leadership, and both internal and external clients.

• Carry out additional duties as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• Graduate from an accredited nursing school or hold a Bachelor's degree with 4+ years of relevant experience.

• Possess a license for independent practice and/or state-required licensure.

• LCSW (Licensed Clinical Social Worker) certification is mandatory, or possess LMHC, LPC, LMFT, LMHP, RN state/compact licensure, or BCBA certification.

• Familiarity with behavioral health utilization management principles is preferred.

• Previous supervisory experience is advantageous.

• Understanding of medical necessity criteria for a wide range of behavioral health services is preferred.

• Experience in leading clinical teams is required.

• Capability to lead and manage others in a matrixed or cross-functional environment.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K plan.

• Stock purchase options.

• Tuition reimbursement programs.

• Paid time off along with holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional incentive opportunities may be included in total compensation.

• Equal opportunity employer dedicated to fostering diversity.