Supervisor, Behavioral Health Utilization Management

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

📋 Description

• Oversee the daily operations of the behavioral health utilization management team and supervise the clinicians involved in utilization reviews.

• Ensure that clinicians adhere to the relevant guidelines and regulations.

• Track and assess behavioral health utilization management resources in relation to performance, quality, and efficiency benchmarks.

• Address and resolve intricate behavioral health care member concerns.

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

• Collaborate with the team and senior management to identify opportunities for process and quality enhancements.

• Provide education and resources on significant initiatives while facilitating communication among the team, members, and providers.

• Develop and enforce policies, procedures, and guidelines for utilization management.

• Assess team performance and offer constructive feedback regarding performance, objectives, and career progression.

• Mentor and support the team; provide counseling and corrective actions as necessary.

• Assist with the recruitment, onboarding, and training of team members.

• Represent the team in company meetings when the people leader is unavailable.

• Serve as the primary contact for escalated calls and issues that require detailed research or special handling.

• Guide and manage personnel within a matrixed and cross-functional environment.

• Advocate for and lead changes within the scope of responsibility.

• Present information and address inquiries from peers, leaders, and both internal and external customers.

• Carry out additional duties as assigned.

• Adhere to all company policies and standards.

⛳️ Requirements

• Candidates must be residents of North Carolina.

• Must possess one of the necessary licenses or certifications: NC LCSW, LMHC, LPC, LMFT, LMHP, RN with state or compact state licensure, or BCBA for ABA.

• Graduate from an Accredited School of Nursing or hold a Bachelor's degree.

• A minimum of 4 years of relevant experience is required.

• Must have a license for independent practice and/or possess the required state licensure.

• Preferred knowledge of behavioral health utilization management principles.

• Prior supervisory experience is preferred.

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

• Availability to work Monday through Friday from 8:00 AM to 5:00 PM, including a rotating weekend on-call schedule.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K and stock purchase plans available.

• Tuition reimbursement offered.

• Paid time off in addition to holidays.

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