Supervisor, Behavioral Health Utilization Management

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

📋 Description

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

• Ensure that clinicians adhere to relevant guidelines.

• Monitor BH utilization management resources in relation to performance, quality, and efficiency benchmarks.

• Address complex issues related to behavioral health member care.

• Stay updated on regulations, accreditation standards, and industry best practices.

• Recognize opportunities for process and quality enhancements in collaboration with the team and senior management.

• Provide education and resources to the team regarding important initiatives.

• Create and implement policies, procedures, and guidelines for utilization management.

• Assess team performance and offer feedback on objectives and career development milestones.

• Mentor and support team members, providing counseling and corrective action as necessary.

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

• Participate in company meetings when the people leader is unavailable.

• Act as the primary contact for escalated calls and issues needing research or special handling.

• Lead and manage teams within a matrixed/cross-functional environment.

• Advocate for change within the defined scope of responsibility.

• Present information and answer questions from peers, leadership, and both internal and external customers.

• Execute other assigned tasks and adhere to all policies and standards.

⛳️ Requirements

• Graduate from an Accredited School of Nursing or hold a Bachelor's degree with 4+ years of relevant experience.

• Possess a license to practice independently and/or meet state licensure requirements.

• Hold an active clinical license in Texas.

• One of the following: LCSW, LMHC, LPC, LMFT, LMHP, RN state/compact state licensure, or BCBA license/certification as applicable.

• Familiarity with BH utilization management principles is preferred.

• Previous supervisory experience is preferred.

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

• Knowledge of various levels of care and the Texas Administrative Code is preferred.

• Awareness of Local Mental Health Authorities (LMHAs) guidelines is preferred.

• Experience in conducting retrospective audits is preferred.

• Knowledge of Medicaid, community mental health, foster care, Texas Department of Family and Protective Services, or Child Protective Services is preferred.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K plan.

• Stock purchase options.

• Tuition reimbursement program.

• Paid time off in addition to holidays.

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

• Additional incentives may be included in total compensation.

• Equal opportunity employer dedicated to diversity.