Associate Director, Utilization Management – Behavioral Health
CareSource
full-time
Posted on:
Location Type: Office
Location: Boston • Massachusetts • United States
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Salary
💰 $113,000 - $197,700 per year
Job Level
About the role
- Assist UM leadership in leading and managing all functions within behavioral health management
- Collaborate with market and enterprise leaders to support development and knowledge transfer for Behavioral Health UM
- Monitor effective use of prior authorizations, policies, and benefits
- Facilitate and promote problem identification, analysis, and resolution
- Ensure Behavioral Health UM programs and operational processes are properly developed and aligned to the organization’s strategic goals
- Identify and report risk management issues for the department and CareSource as a whole
Requirements
- Bachelor’s degree in nursing or related field required or equivalent years of relevant experience required
- Minimum of five (5) years of experience in utilization management in an MCO required
- Minimum of three (3) years management experience required
- Proficiency in Microsoft Office products including Word, Excel and PowerPoint
- Clinical data analysis and trending skills
- Knowledge of trends in healthcare, managed care, Medicaid, behavioral health, and quality improvement
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Professional development opportunities
- Bonus tied to company and individual performance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
utilization managementclinical data analysisdata trending
Soft Skills
problem identificationproblem analysisproblem resolutioncollaborationleadership
Certifications
Bachelor’s degree in nursingBachelor’s degree in related field